Nevin TÜTEN, Koray GÖK, Mine KUCUR, Abdullah Serdar AÇIKGÖZ, Mahmut ONCUL, Abdullah TÜTEN

Gestasyonel Diyabetes Mellituslu Gebelerde Serum YKL-40 Düzeyi

Amaç: GDM’lu ve sağlıklı gebelerde anne serumunda YKL-40 düzeyini ölçerek bu gebelerdeki insülin direnci üzerindeki rolünü açıklığa kavuşturmaktır. Yöntem: Haziran 2012 ile Haziran 2013 tarihleri arasında Cerrahpaşa Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı'nda takip edilen 40 GDM ve 40 sağlıklı term gebe çalışmaya dahil edildi. Gebelere ait demografik ve klinik parametreler hasta dosyalarından alındı. Bu gebelerde açlık glukoz, HbA1C, açlık insülin ve YKL-40 düzeyi ölçüldü. HOMA-IR değeri hesaplandı. GDM’li ve sağlıklı gebelerdeki parametreler karşılaştırıldı. Serum YKL-40 düzeyinin insülin direnci parametreleriyle ilişkisi araştırıldı. Bulgular: GDM’lu ve sağlıklı gebeler arasında yaş, sistolik ve diyastolik kan basıncı, gebelik haftası, doğum ağırlığı, lökosit sayısı ve açlık glukoz düzeyi açısından istatistiksel bir fark saptanmadı (tümü için p > 0.05). GDM'lu gebelerin VKİ, HbA1c, açlık insülin düzeyi, HOMA-IR değeri ve YKL-40 düzeyi istatiksel açıdan anlamlı olacak şekilde yüksek saptandı ( sırasıyla, 31.8 ± 4.3, 28.1 ± 2.4, p:0,001; 5.86 ± 1.85, 5.11 ± 0.25, p:0,001; 12.74 ± 6.52, 7.44 ± 2.12, p:0,001, 3.12 ± 1.94, 1.81 ± 0.48, p:0,001). Serum YKL-40 düzeyi VKİ, HbaA1C, açlık insülin,ve HOMA-IR değeri ile pozitif korele saptandı(sırasıyla, r:0,507, p:0,001; r:0,668, p:0,001; r:0,556, p:0,001; r:0,379, p:0,009). Sonuç: GDM’lu gebelerde serum YKL-40 düzeyinin arttığı ve bu düzeyin insülin direnci parametreleriyle pozitif korele olduğu tespit edilmiştir.

Anahtar Kelimeler:

GDM, İNSÜLİN DİRENCİ, HOMA-IR, YKL-40

Serum YKL-40 Level in Pregnant Women with Gestational Diabetes Mellitus

Objective: To clarify its role on insulin resistance in pregnant women with GDM and by measuring the level of YKL-40 in maternal serum. Materials and Methods: 40 GDM and 40 healthy term pregnant women followed in Cerrahpaşa Medical Faculty, Department of Obstetrics and Gynecology between June 2012 and June 2013 were included in the study. Demographic and clinical parameters of pregnant women were obtained from patient files. Fasting glucose, HbA1C, fasting insulin and YKL-40 levels were measured in these pregnant women. The HOMA-IR value was calculated. The parameters of GDM and healthy pregnant women were compared. The relationship between serum YKL-40 level and insulin resistance parameters was investigated. Results: There was no statistical difference between GDM and healthy pregnant women in terms of age, systolic and diastolic blood pressure, gestational week, birth weight, leukocyte count and fasting glucose level (p > 0.05 for all). BMI, HbA1c, fasting insulin level, HOMA-IR value and YKL-40 level were found to be statistically significantly higher in pregnant women with GDM (31.8 ± 4.3, 28.1 ± 2.4, p:0.001; 5.86 ± 1.85, 5.11 ± 0.25, respectively). , p:0.001, 12.74 ± 6.52, 7.44 ± 2.12, p:0.001, 3.12 ± 1.94, 1.81 ± 0.48, p:0.001). Serum YKL-40 level was positively correlated with BMI, HbaA1C, fasting insulin, and HOMA-IR value (respectively, r:0.507, p:0.001; r:0.668, p:0.001; r:0.556, p:0.001; r: 0.379, p:0.009). Conclusion: It was determined that serum YKL-40 level increased in pregnant women with GDM and this level was positively correlated with insulin resistance parameters.

Keywords:

GDM, INSULIN RESISTANCE, HOMA-IR, YKL-40,

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