Tolga Altuğ ŞEN, Ayşegül BÜKÜLMEZ, Tevfik DEMİR, Reşit KÖKEN

Tip 1 diyabetli kız olgularda glisemik kontrolün plazma ghrelin ve serum IGF-1 düzeylerine etkisi

Giriş: Çalışmamızda Tip 1 diyabetli kız olgularda glisemik kontrolün plazma ghrelin düzeyleri ve serum IGF-1 düzeyleri üzerine etkisini göstermeyi amaçladık. Gereç ve Yöntem: Çalışmamızda yaşları 14-20 yıl arasında, puberte Tanner evre 5 olan 32 tip 1 diyabetli kız olgu seçildi. Bu olgular son 1 yıllık ortalama glikozile hemoglobin ölçümlerine göre 18’i metabolik kontrolü iyi, 14’ü metabolik kontrolü kötü olarak 2 gruba ayrıldılar. Kontrol grubu olarak yaş ve puberte açısından benzer 15 sağlıklı kız çocuk seçildi. Olguların sabah açlık plazma ghrelin düzeyleri ve serum IGF-1 düzeyleri ölçüldü. Bulgular: Ortalama ghrelin düzeyleri metabolik kontrolü iyi olan tip 1 diyabetli olgularda 483,4±221,9 pg/ml, metabolik kontrolü kötü olan olgularda 310,7±110,2 pg/ml ve sağlıklı kontrollerde 471,9±175,0 pg/ml bulundu. Ortalama IGF-1 düzeyleri iyi metabolik kontrollü olgularda 233,9±59,2 ng/ml, kötü metabolik kontrollü olgularda 183,9±36,7 ng/ml, sağlıklı kontrollerde ise 247,3±48,5 ng/ml bulundu. İyi metabolik kontrollü olgularla sağlıklı kontroller arasında plazma ghrelin ve serum IGF-1 düzeyleri için anlamlı fark yoktu. Metabolik kontrolü kötü olan diyabetlilerde ghrelin ve IGF-1 düzeylerinin diğer iki gruba göre baskılandığı gözlendi. Sonuç: Tip 1 diyabetli olgularda metabolik kontrol plazma ghrelin ve serum IGF-1 düzeyleri için belirleyici bir faktör olabilir. Metabolik kontrolü iyi olan olgularda ghrelin ve IGF-1 düzeyleri kontrol grubundaki olgularla benzer bulunurken, metabolik kontrolü kötü olan olgularda ghrelin ve IGF-1 düzeylerinin baskılandığı görülmüştür.

The effect of glycemic control on plasma ghrelin and serum IGF-1 levels in type 1 diabetic girls

Introduction: The aim of this study was to investigate the effect of glycemic control on plasma ghrelin levels and serum IGF-1 levels in girls with type 1 diabetes.Materials and Method: The study group composed of 32 diabetic girls between the ages of 14.0-20.0 years with Tanner pubertal stage 5; and 15 healthy girls in similar ages with Tanner pubertal stage 5 formed the control group. Diabetic girls were classified as well glycemic controlled (n=18) and poor glycemic controlled (n=14) according to last year’s mean glycosylated hemoglobin levels. All subjects were tested for fasting plasma ghrelin and serum IGF-1 levels. Results: The mean fasting plasma ghrelin levels in girls with well controlled diabetes, in girls wtih poor controlled diabetes and in control group were 483.4±221.9 pg/ml, 310.7±110.2 pg/ml, 471.9±175.0 pg/ml respectively. The mean serum IGF-1 levels in girls with well controlled diabetes was 233.9±59.2 ng/ml, in girls with poor controlled diabetes 183.9±36.7 ng/ml, and in healthy controls 247.3±48.5 ng/ml. Plasma ghrelin levels and serum IGF-1 levels were similar in girls with well controlled diabetes and in the control group, however it was significantly supressed in those with poorly controlled diabetes. Conclusion: The metabolic control may be a determinative factor on plasma ghrelin and serum IGF-1 levels of type 1 diabetics. Plasma ghrelin and serum IGF-1 levels were similar in well glycemic controlled diabetics and control group, while they were suppressed in only poor glycemic controlled diabetics.

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