Tip 2 Diyabetli Hastalarda Serum Resistin Düzeyleri İle Obezite ve İnsülin Direnci Arasındaki İlişki

Amaç: Tip 2 diyabetes mellitus (DM) hedef dokunun insüline dirençli olması ile karakterize olup obezite ile yakın ilişkilidir. Resistin yağ dokusundan türeyen bir hormon olup Tip 2 DM, obezite, insülin direnci ve inflamasyonla ilişkilendirilmektedir. Bu çalışmamızın amacı Tip 2 DM , bozulmuş glukoz toleransı olan (IGT) ve normal glukoz toleransı (NGT) olan gruplar arasındaki serum resistin seviyelerini karşılaştırmak ve bu seviyelerin obezite ve insülin direnciyle ilişkisini araştırmaktır. Mateyal ve Metod: Çalışma gruplarımız toplam 72 kişiden oluşmaktadır. Serum resistin konsantrasyonlarını NGT(n=25), IGT(n=23) ve Tip 2 DM’lu grupların(n=24) glukoz, insülin, HbA1c, BMI, HOMA ve bel/kalça oranı ile karşılaştırdık. Daha sonra 72 vaka beden kütle indeksine(BMI) ve HOMA-IR skoruna göre alt gruplara bölündü; obez olmayan BMI<25 kg/²(43 vaka), obez BMI>25kg/²(29 vaka), HOMA-IR(+)(23 vaka) ve HOMA-IR(-)(49 vaka). Açlık serum resistin seviyesi ELISA yöntemi ile ölçüldü. İnsülin direnci HOMA-IR formülüne göre hesaplandı. Bulgular: NGT, IGT ve Tip 2 DM grupları arasında serum resistin seviyeleri bakımından istatistiksel anlamlı farklılık yoktu(p>0,05). Obez olmayan gruba göre obez grupta daha yüksek serum resistin seviyeleri görüldü(p<0,01). HOMA skoru NGT grubuna göre IGT ve Tip 2 DM gruplarında daha yüksek bulundu(p<0,01). HOMA-IR(-) grup ve HOMA-IR(+) grupları arasında resistin seviyeleri bakımından istatistiksel anlamlı fark gözlenmedi(p>0,05). NGT grubunda resistin ile bel/kalça oranı arasında , IGT grubunda serum resistini ile açlık kan glukozu, sistolik kan basıncı, yaş arasında negatif korelasyon bulundu. (Sırasıyla; r=-0,45,p<0,05; r=-0,59,p<0,05; r=-0,53,p<0,01; r=0,46; r=0,45, p<0,05). Sonuç: Resistinin glukoz metabolizmasını etkileyebileceğini, obezite ile ilişkili olabileceğini ancak insülin direnci ve diyabeti dolaylı yollardan etkileyebileceğini düşünmekteyiz. Anahtar Kelimeler: Diyabetes Mellitus, HOMA, obezite, resistin Aim: Type 2 diabetes mellitus (DM) characterized by target-tissue resistance to insülin and it is strongly linked to obesity. The adipocytes derived hormone resistin is involved in tip 2 DM, obesity, insülin resistance and iflammation. The aim of this study is to compare serum resistin levels between in normal glucose tolerance group (NGT), impaired glucose tolerance group (IGT) and Type 2 DM group and investigate correlations with obesity and insulin resistance. Materials ve Methods: Firstly, we compared serum concentrations of resistin with glucose,insülin,HbA1C, BMI,HOMA and waist-to-hip ratio in subject with NGT(n=25), IGT(n=23) and type 2 DM(n=24).Later, according to the body mass index(BMI) and homeostasis model assesment of insulin resistance(HOMA-IR) score 72 cases were divided into subgroups; nonobese with BMI<25 kg/²(43 cases), the obese with BMI>25kg/²(29 cases), HOMA-IR(+)(23 cases) and HOMA-IR(-)(49 cases). Fasting serum resistin level was measured by ELISA. Insulin resistance was measured by the(HOMA-IR) formula. Results: There was no statisfically difference in resistin levels between NGT, IGT and Type 2 DM gorups(p>0,05). Compared with non obese group, obese group showed higher serum resistin levels(p<0,01). HOMA score was found significantly higher in the IGT and Type 2 DM groups than NGT group(p<0,01). Between HOMA-IR(-) group and HOMA-IR(+) group no significant difference was observed between in the levels of resistin(p>0,05). A significant negative correlation observed between resistin and blood glucose waist-to-hip ratio (r=0,45,p<0,05) in NGT group, between resistin and fasting blood glucose, systolic blood pressure, age in IGT group (respectively;r=-0,45,p<05;r=-0,59,p<05;r=-0,53,p<0,01;r=0,46;r=0,45,p<0,05). Conclusion: We concluded that resistin may effect glucose metabolism, linked with obesity but indirectly effect insülin resistance and diabetes. Key Words: Diabetes Mellitus, HOMA, obesity, resistin

Anahtar Kelimeler:

Diyabetes Mellitus, HOMA, obezite, resistin

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