Nuri ÇAKIR, Müjde AKTÜRK, Füsun TÖRÜNER, Alev ALTINOVA EROĞLU, Metin ARSLAN

Tip 2 diyabetli hastalarda apob, non-hdl kolesterol düzeyleri ve apob/apo a-1 oranının değerlendirilmesi

Amaç: Apo B, non-HDL kolesterol (non-HDL-K) düzeyinin ve Apo B/Apo A-1oranının, artmış kardiyovasküler hastalık (KVH) riski açısından en az LDLkolesterol (LDL-K) kadar önemli olabileceği söylenmektedir. Çalışmamızda tip2 diyabetli hastalarda bu parametreleri inceledik.Yöntem: Gazi Üniversitesi Tıp Fakültesi Diyabet ve Obezite polikliniğinebaşvuran, statin kullanmayan ve serum LDL-K düzeyi 100 mg/dlnin altındaolan tip 2 diyabetli 40 hasta (21 kadın, 19erkek) çalışmaya alındı.Bulgular: Ortalama LDL-K 85,6±15,5 mg/dl, HDL-K46,7±8,9 mg/dl, trigliserid150,1±71,8 mg/dl, non-HDL-K 118,5±22,4 mg/dl, Apo B-100 81,5±16,5 mg/dl,Apo A-1 138,6±22,4 mg/dl ve Apo B/Apo A-1 oranı 0,6 ± 0,1 olarak bulundu.Apo Bsi yüksek (≥90 mg/dl) hasta oranı %29,7, non-HDL-Kü yüksek(>130mg/dl) hasta oranı %21,6 bulundu. Apo B/Apo A-1 oranı yüksek(kadında> 0,8, erkekte >0,9) hasta oranının %8,1 olduğu görüldü. Ayrıca,serum Apo B düzeyi ile postprandiyal kan şekeri (r=0,36, p=0,02) arasındapozitif yönde anlamlı bir ilişki saptandı. Non-HDL-K, Apo B/Apo A-1 oranı ileglisemik ayar arasında anlamlı ilişki saptanmadı (p>0,05).Sonuç: Çalışmamızda LDL-K hedef değerin altında olan tip 2 diyabetlihastaların yaklaşık üçte birinde Apo B ve beşte birinde non-HDL-Kdüzeylerinin yüksek olduğu gözlenmiştir. Bu nedenle tip 2 diyabetlihastalarda KVH risk değerlendirmesinde Apo B ve non-HDL-K gibiparametrelerin de göz önünde bulundurulması önemlidir. Ayrıcaçalışmamızda saptadığımız tokluk glisemi düzeyi ile Apo B arasındaki ilişki,postprandiyal glisemik kontrolün Apo B düzeyleri üzerinde etkisi olabileceğinidüşündürmektedir.

Evaluation of apo b, non-hdl cholesterol levels and apo b/apo a-1 ratio in patients with type 2 diabetes

Objective: Apo B, non-HDL cholesterol (non-HDL-C) levels and ApoB/Apo A-1 ratio have been suggested to be as important as LDL cholesterol (LDL-C) in terms of increased risk of cardiovascular disease (CVD). We examined these parameters in patients with type 2 diabetes (T2DM). Methods: Forty patients with T2DM (21 females, 19 males) attending Diabetes Clinic of Gazi Medical Faculty were enrolled. Patients were not using statin and their serum LDL-C level were below 100 mg/dl. Results: The mean LDL-C was 85.6±15.5 mg/dl, HDL-C,46.7± 8.9 mg/dl, triglycerides,150.1±71.8 mg/dl, non-HDL-C, 118.5 ±22.4 mg/dl, Apo B-100, 81.5±16.5 mg/dl, ApoA-1, 138.6±22.4 mg/dl and ApoB/Apo A-1 ratio, 0.6± 0,1. The percentages of the patients with high Apo B and high non-HDL-C were 29.7% and 21.6%. High Apo B/Apo A-1 ratio was found as 8.1%. In addition, serum Apo B levels showed a significant positive relationship with postprandial blood glucose (PBG)(r=0.36, p=0.02). Conclusion: In our study, we observed that approximately one third of thepatients with T2DM had high Apo B and one fifth had high non-HDL-C levels even if the LDL-C is on target values. For this reason, it is important that Apo B and non-HDL-C should be taken into consideration for the assessment of CVD risk in patients with T2DM. In addition, our finding that the relationship between PBG and Apo B suggests that postprandial glycemic control may have an impact on Apo B levels.

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