Tip 2 Diyabetli Hastalarda Kan Glukoz Düzeyi ile Karbonmonoksit Difüzyon Kapasitesi Arasındaki İlişki

Özet Amaç: Diyabetes mellitus birçok organı etkileyen komplikasyonlarla giden bir hastalıktır. Diyabetin retinopati, nefropati, nöropati ve makrovasküler komplikasyonları iyi bilinmekle birlikte akciğer üzerine etkileri yeteri kadar çalışılmamıştır. Bizim bu çalışmamızda amacımız tip 2 diyabetes mellitus’un solunum fonksiyon testlerine etkisin incelemektir. Gereç ve Yöntemler: Tip 2 diyabetli 51hasta (15’i erkek, 36’sı kadın) ve 49 sağlıklı kontrol (24’ü erkek, 25’i kadın) olmak üzere toplam 100 kişi çalışmaya dâhil edildi. Diyabetli hastalardan 8-12 saatlik açlık kan şekeri, HbA1c, tokluk kan şekeri, kreatinin, alanin Transaminaz (ALT), hemogram, spot albümin, spot kreatinin tahlilleri istendi. Tüm hastaların göz ve nörolojik muayeneleri ilgili branşlarda yaptırıldı ve diyabetik nöropati, nefropati veya retinopati saptanan hastalar kaydedildi. Tüm katılanların solunum fonksiyon testleri yapılarak 1 saniyedeki zorlu ekspiratuar volüm (FEV1), zorlu ekspiratuar volüm 1 sn/zorlu vital kapasite (FEV1/FVC), karbonmonoksit difüzyon kapasitesi (DLCO%) değerler ölçüldü ve iki grup arasında karşılaştırmalar yapıldı. Bulgular: Diyabetli hastalarda FEV1 değeri ortalama 92.84±8.94 ml iken, kontrol grubunda 96.95±9.2 ml olarak saptandı. Diyabetli grupta FEV1 daha düşük bulundu ve arasındaki fark istatistiksel olarak anlamlıydı (p=0.026). Diyabetli hastalarda DLCO değeri 96.21±10.8 mmol/kPa/dk iken kontrol grubunda bu değer 97.95±10.1 mmol/kPa/dk idi ve tip 2 diyabetlilerde daha düşük olmasına rağmen aralarındaki fark anlamlı değildi (p=0.41). Diyabetli hastalarda FEV1/FVC oranı 82.15±6.77 iken, kontrol grubunda ise 83.73±5.87 olarak saptandı ve aralarındaki fark anlamlı değildi (p=0.21). Sonuç: Tip 2 diyabetli hastalarda kronik hiperglisemi olması mikroanjiopatik hasara yol açarak özellikle retinopati, nöropati ve nefropati gibi komplikasyonlara sebebiyet vermektedir. Diyabetin akciğer üzerindeki etkilerini inceleyen çalışma sayısı çok azdır. Çalışmamızda tip 2 diyabetli olanlarda kontrol grubuna göre solunum fonksiyonlarında sadece FEV1 değerlerinde bozulma olduğunu saptadık. Bununla birlikte bu konuda daha geniş kapsamlı çalışmalara ihtiyaç olduğunu düşünmekteyiz.

Anahtar Kelimeler:

DİYABETES MELLİTUS, TİP 2 DİYABET, SOLUNUM FONKSİYON TESTİ, FEV1, FEV1/FVC, DLCO

Relationship Between Blood Glucose Level and Carbonmonoxide Diffusion Capacity in Patients with Type 2 Diabetes

Abstract Objective: Diabetes mellitus is a chronic disease that causes complications and affects many organs. Even though retinopathy, neuropathy, nephropathy and macrovascular complication of diabetes are well known. There are less study about lung involvement. In this study our aim was to investigate the effects of diabetes on respiratory function tests. Material and Methods: Fifty one diabetic patients (15 male, 36 female) and 49 healthy controls (24 male, 25 female), total 100 participants were involved to our study. Fasting blood glucose, HbA1c, after meal blood glucose, creatinine, hemogram, alanine transaminase (ALT), spot urine albumin and spot urine creatinine samples were taken from diabetic patients. All patients were screened for microvascular complications and data was recorded. Respiratory function tests were performed in all participants and Forced expiratory volume in 1st second (FEV1), Forced expiratory volume in 1st second/forced vital capacity (FEV1/FVC), carbon monoxide diffusing capacity (DLCO%) were measured and compared between two groups. Results: FEV1 values of diabetic group and control group were 92.84±8.94 ml and 96.95±9.2 ml respectively, FEV1 values of diabetic group were statistically significant (p=0.026). DLCO levels in diabetic group and control group were 96.21±10.8 mmol/kPa/min, and 97.95±10.1 mmol/kPa/min respectively, even though diabetic group has lower DLCO levels, this finding was not statistically significant (p=0.41). FEV1/FVC levels of diabetic and control group were 82.15±6.77 and 83.73±5.87 respectively and difference was not statistically different (p=0.21). Conclusion: Chronic hyperglycemia in diabetes may cause microangiopathic damage and leads to microvascular complications such as retinopathy, nephropathy and neuropathy. Studies about effects of diabetes on lungs is quite limited. In our study we detected lower FEV1 levels in diabetic patients compared with healthy controls. More studies are required to clarify lung involvement in diabetes.

Keywords:

DIABETES MELLITUS, TYPE 2 DIABETES, RESPIRATORY FUNCTION TESTS, FEV1, FEV1/FVC,

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