Flora ÖZKALCI, Ali KARAGÖZ, Işıl KUTLUTÜRK KARAGÖZ, Süleyman Çağan EFE, İbrahim Halil TANBOĞA, Cihangir KAYMAZ, Erdem TÜRKYILMAZ

Diyabetik Hastalarda Sol Atriyal Strain ile Malnütrisyon Skorlarının İlişkisi

olumsuz sonlanımlarla ilişkili ciddi bir halk sağlığı sorunudur. Malnütrisyonun çeşitli hastalıklara eşlik ettiği önceki çalışmalarda gösterilmiştir. Öte yandan malnütrisyonun, diyabetik retinopatinin eşlik ettiği diyabetik hastaların kalp fonksiyonlarına etkisi konusunda yeterli kanıt bulunmamaktadır. Çalışmamızda bu hasta grubunda malnütrisyon varlığı ile kardiyak fonksiyonlar arasındaki ilişkinin sol atriyal strain analizi ile değerlendirilmesi amaçlanmıştır. Hastalar ve Yöntem: Tarafımıza sevk edilen diyabetik retinopati tanısı almış diyabetik hastaların verileri geriye dönük incelendi. Sinüs ritmi olan, ciddi kapak hastalığı ve koroner arter hastalığı bulgusu olmayan, konvansiyonel ekokardiyografiyle birlikte strain analizi yapılmış ve önceki muayenelerinde malnütrisyon açısından değerlendirilmiş olan hastalar çalışmaya alındı. Yüz yetmiş hasta dahil edilme kriterlerini karşıladı. Hastaların beslenme durumlarını değerlendirmek için CONUT skoru, NRI ve PNI gibi malnütrisyon skorları kullanıldı. Bulgular: CONUT skoruna göre, tüm diyabetik hastaların %30’unun malnütrisyona sahip olduğu gösterilmiştir. Sol atriyal kondüit strain değerinin malnütrisyon ile azaldığı gösterilmiştir [ß: -7.5 (CI %95, -10.7, -4.3 p< 0.001)], sol atriyal rezervuar strain değerinin malnütrisyon ile arttığı gösterilmiştir [ß: 2.48 (CI %95 0.83-4.13 p< 0.03)] ve sol atriyal kontraktil strain değerinin malnütrisyon ile azaldığı gösterilmiştir [ß: -4.21 (CI %95, -2.21, -6.01 p< 0.001)]. Sonuç: Bu çalışmada, malnütrisyonun diyabetik hastalarda sol atriyal strain üzerine etkisi gösterilmiştir.

Relationship Between Left Atrial Strain and Malnutrition Scores in Diabetic Patients

Introduction: Malnutrition is a serious public health problem that is associated with adverse outcomes in a broad range of disease including cardiovascular disease and diabetes mellitus. Malnutrition is demonstrated to be accompanying to several disease, yet there is a lack of evidence on the impact of malnutrition on cardiac functions in patients with diabetic patients with diabetic retinopathy. Herewith our primary goal was to evaluate the relation between any degree malnutrition with left atrial strain in relevant patient group. Patients and Methods: Patients with diabetes mellitus with retinopathy, who were referred to the outpatient cardiology clinic were assessed. Those who had sinus rhythm, had no findings of significant valvular heart disease or coronary artery disease underwent to 2-dimensional speckle tracking echocardiography and assessed for malnutrition in their prior examinations were included to the study. Hundred and seventy patients met the inclusion criteria. Malnutrition scores such as Controlling Nutritional Status score (CONUT), nutritional risk index (NRI) and The Prognostic Nutritional Index score (PNI) index were used to evaluate nutrition condition of the patients. Results: Thirty percent of all diabetic patients were demonstrated to have malnutrition according to the CONUT score. Left atrial conduit strain was demonstrated to decrease [ß: -7.5 (CI 95%, -10.7, -4.3 p< 0.001)], Left atrial reservoir strain was demonstrated to increase [ß: 2.48 (CI 95%,0.83-4.13 p< 0.03)] and Left atrial contractile strain was demonstrated to decrease [ß: -4.21 (CI 95%, -2.21, -6.01 p< 0.001)] in the presence of any degree malnutrition. Conclusion: In this study we have demonstrated that malnutrition is an important entity in patients with diabetes mellitus and has a significant impact on left atrial strain.

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi