Taner ŞEN, Erkan KAHRAMAN, Saadet GÜVEN, Serkan TOPALOĞLU, Şule KORKMAZ

Tip 2 Diabetes Mellituslu Hastalarda Glikolize Hemoglobin (Hemoglobin A1c) ile Aortik Sertlik Arasındaki İlişki

Giriş: Tip 2 diabetes mellitus (DM) kardiyovasküler hastalıklar için major risk faktörüdür ve DM’li hastalar artmış kardiyovasküler mortalite ve morbiditeye sahiplerdir. Kronik hiperglisemi ile ilişkili olan birçok mekanizma bu hızlanmış aterosklerozdan sorumlu tutulmaktadır. Bu çalışmada amaç DM’li hastalarda uzun dönem glisemik kontrolün belirteci olan HbA1c seviyesi ile kardiyovasküler hastalıkların belirteci olan aortik sertlik arasındaki ilişkiyi saptamaktır. Hastalar ve Yöntem: Çalışmamıza kliniğimize başvuran Tip 2 DM’li 100 hasta alındı. Hastalar HbA1c değerlerine göre üç gruba ayrıldı. Bulgular: Gruplar arasında açlık kan şekerleri, DM süresi ve oral antidiyabetik ya da insülin kullanımında istatistiksel olarak anlamlı şekilde farklı bulundu. Aortik esneyebilirlik ve HbA1c düzeyi arasında önemli ilişki bulundu (r= 0.283; p= 0.004). Bunun yanı sıra, DM süresi (r= -0.172; p= 0.05) açlık kan şekeri (r=0.292; p= 0.003) ve hasta yaşı ile (r= -0.27; p= 0.006) aortik esneyebilirlik arasında da istatistiksel anlama ulaşan korelasyon tespit edildi. Bunun yanında aortik gerilim ile açlık kan şekeri, HbA1c, DM süresi arasında (sırasıyla; r= -0.265; p= 0.008, r= 0.279; p= 0.005 ve r= -0.14; p= 0.03) anlamlı korelasyon bulundu. Sonuç: Bu çalışmada, yüksek açlık kan şekeri ve HbA1c düzeyine sahip tip 2 diyabet hastalarında aortik sertliğin arttığını gösterdik. Aynı zamanda çalışmamız diyabetin süresi ile aortik sertliğin ilişkili olduğunu göstermiştir. Ekokardiyografiyle noninvaziv yöntem olarak ölçülen aortik elastisite parametreleri hastalığın erken döneminde kardiyovasküler riski tahmin etmede ve önlemede faydalı olabilir.

Anahtar Kelimeler:

Aortik sertlik, diabetes mellitus

Relation Between Glycosylated Hemoglobin (Hemoglobin A1c) and Aortic Stiffness in Patients with Type 2 Diabetes

Introduction: Type 2 diabetes mellitus (DM) is a major risk factor for cardiovascular diseases and is responsible for the increase in cardiovascular mortality. Chronic hyperglycemia is related to accelerated atherosclerosis. In this study, we tried to demonstrate the relation between glycosylated hemoglobin (HbA1c) level, which is a marker of long-standing hyperglycemia, and aortic stiffness, which is a marker of cardiovascular disease. Patients and Methods: In total, 100 patients with type 2 DM were included in this study. Patients were divided into three groups according to the HbA1c level (group 1 HbA1c ≤ 6, group 2 HbA1c between 6 and 7, and group 3 HbA1c ≥ 7). Results: Significant correlation was found between aortic distensibility and HbA1c level (r= 0.283, p= 0.004). Moreover, aortic distensibility was also correlated with the duration of DM (r= −0.172, p= 0.05) and age (r= -0.27, p= 0.006). Significant correlation was determined between aortic strain and fasting blood glucose level, HbA1c level, and the duration of DM (r= −0.265, p= 0.008; r= 0.279, p= 0.005; and r= −0.14, p= 0.03, respectively). Conclusion: In this study, we showed that aortic stiffness was increased in patients with type 2 DM who have high blood fasting glucose and HbA1c levels. Our study also showed that the duration of DM was related to aortic stiffness. Echocardiographic non-invasive evaluation of aortic stiffness may be helpful in the estimation of cardiovascular risk in patients with DM.

Keywords:

Aortic stiffness, diabetes mellitus,

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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