PREDİYABETİK HASTALARDA SERUM UROTENSİN 2, HS-CRP, VÜCUT YAĞ YÜZDESİ VE İNSÜLİN DİRENCİ ARASINDAKİ İLİŞKİNİN İNCELENMESİ

Giriş: Araştırmamızda ürotensin II, hs-CRP, Vücut yağ yüzdesi ve insülin direnci arasındaki ilişki incelenerek prediyabet patogenezinin anlaşılması amaçlanmıştır. Gereç ve yöntem: Çalışmaya 40 prediyabetik hasta ile 40 kontrol grubu olmak üzere toplam 80 hasta dahil edildi. Her iki grubun kanları ürotensin II düzeyi, hsCRP düzeyi, insülin direnci ve vücut yağ yüzdesi açılarından çalışıldı. İnsülin direnci HOMA-IR ve QUICKI yöntemleriyle hesaplandı. Bulgular: Araştırmamızda prediyabetik hastalarda serum ürotensin II düzeyi kontrol grubundaki hastalara göre istatistiksel olarak yüksek saptandı p=0.004 . Serum ürotensin II düzeyi ile insülin direnci göstergesi olan HOMAIR, sistolik kan basıncı ve diyastolik kan basıncı arasında anlamlı bir ilişki saptandı. Bu bulgular ile prediyabetin oluşumundaki temel mekanizmanın insülin direnci gelişimi ve insülin direnci gelişimindeki patofizyolojide ürotensin II düzeyi yüksekliğinin önemli bir rol oynuyor olabileceği gösterilmiş oldu. Sonuç: Sonuçta ürotensin II düzeyi ölçümü ile prediyabetin gelişiminin öngürelebileceği ve uygun yaşam tarzı değişikliği ile prediyabet oluşumunun önlenebileceği, ürotensin II ve/veya reseptörüne karşı geliştirilebilecek ajanlar ile prediyabet oluşumunun önlenebileceği veya geciktirilebileceği gösterildi
Anahtar Kelimeler:

Prediyabet, urotensin 2, hs-CRP

THE EXAMINATION OF THE RELATION BETWEEN PLASMA UROTENSIN II; HS-CRP; BODY FAT PERCENTAGE AND INSULIN RESISTANCE IN PREDIABETIC PATIENTS

Introduction: In our study, the aim was to understand prediabetic pathogenesis or prediabetes by examining the relation between Urotensin II, hs-CRP; body fat index and insulin resistance. Material and Methods: To our trial, 40 control and 40 prediabetic patients, a total of 80 patients were included. Both group’s blood samples have been examined for urotensin II level, hsCRP level, insulin resistance and body lipid percentage. Their insulin resistance was calculated by using HOMA-IR and QUICKI methods. Results: In our study, in prediabetic patients, plasma urotensin II level was found to be statistically higher than the patients in control group p=0.004 . A significant relation was found between plasma urotensin II level and insulin resistance indicator HOMA-IR; systolic blood pressure and diastolic blood pressure.With these findings, it was shown that a high urotensin II level could have an important role playing in prediabetic development’s basic mechanism, insulin resistance and the development of insulin resistance pathophysiology Conclusion: By determining urotensin II level, prediabetes development could be predicted and with proper life style changes prediabetes could be prevented. Urotensin II and/or agents against its receptor which would be developed in future would demonstrate the ability to prevent or delay prediabetes

___

  • Basevi V, Di Mario S, Morciano C, Nonino F, Magrini N., Comment on: American Diabetes Association. Standards of medical care in diabetes-2011. Diabetes Care 2011;34 (Suppl.1):S11-S61.
  • Armato J, DeFronzo RA, Abdul-Ghani M, Ruby R. Successful Treatment of Prediabetes in Clinical Practice: Targeting Insulin Resistance and Beta Cell Dysfunction. Endocr Pract 2012; 18(3):342-50.
  • DeFronzo, R.A. and M. Abdul-Ghani, Assessment and treatment of cardiovascular risk in prediabetes: impaired glucose tolerance and impaired fasting glucose. Am J Cardiol 108(3 Suppl): p.3B-24B.
  • Buysschaert M., Michael B. Definition of Prediabetes. Medical Clinics of North America 2011;95(2): 289-97.
  • Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 1998;15(7):539–53.
  • Watanabe T, Kanome T, Miyazaki A, Katagiri T. Human urotensin II as a link between hypertension and coronary artery disease. Hypertens Res 2006; 29(6):375-87.
  • Iglewski M, Grant SR. Urotensin II-induced signaling involved in proliferation of vascular smooth muscle cells Vasc Health Risk Manag. 2010; 6: 723-34.
  • Rakowski E, Hassan GS, Dhanak D, Ohlstein EH, Douglas SA, Giaid A.. A role for urotensin II in restenosis following balloon angioplasty: use of a selective UT receptor blocker. J Mol Cell Cardiol 2005;39(5):785-91.
  • Tracy RP, Lemaitre RN, Psaty BM, Ives DG, Evans RW, Cushman M, Meilahn EN, Kuller LH. Relationship of C-Reactive Protein to Risk of Cardiovascular Disease in the Elderly Results From the Cardiovascular Health Study and the Rural Health Promotion Project. Arterioscler Tromb Vasc Biol 1997; 17: 1121-7.
  • Rifai N, Tracy RP, Ridker PM. Clinical Efficacy of an Automated High-Sensitivity C-Reactive Protein Assay. Clin Chem 1999; 45(12): 2136-41.
  • Ridker PM, Cook N. Clinical Usefulness of Very High and Very Low Levels of C-Reactive Protein Across the Full Range of Framingham Risk Scores. Circulation 2004; 109(16): 1955-9.
  • Rifai N, Ridker PM. High-sensitivity C-reactive protein: a novel and promising marker of coronary heart disease. Clin Chem 2001; 47(3): 403-11.
  • Rothkrantz-Kos S, Schmitz MP, Bekers O, Menheere PP, van Dieijen-Visser MP. High-Sensitivity C-Reactive Protein Methods Examined. Clin Chem 2002; 48(2): 359-62.
  • Shiesh SC, Chou TC, Lin XZ, Kao PC. Determination of C-reactive protein with an ultra-sensitivity immunochemiluminometric assay. J Immunol Methods 2006; 311(1-2): 87-95.
  • Macy EM, Hayes TE, Tracy RP. Variability in the measurement of C-reactive protein in healthy subjects: implications for reference intervals and epidemiological applications. Clin Chem 1997; 43(1): 52-8.
  • Watson AM, Olukman M, Koulis C, Tu Y, Samijono D, Yuen D, at all. Urotensin II receptor antagonism confers vasoprotective effects in diabetesassociated atherosclerosis: studies in humans and in a mouse model ofdiabetes. Diabetologia. 2013 May;56(5):1155-65. 100
  • İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi (Medical Journal of İzmir Hospital)