Fahri Halit BEŞİR, Elif ÖNDER, Talha DUMLU, Hülya COŞKUN, Leyla AYDIN YILMAZ, Melih Engin ERKAN, Ömer YAZGAN

Kronik obstrüktif akciğer hastalığında karotis intima mediya kalınlığının değerlendirilmesi

Giriş: Kronik obstrüktif akciğer hastalığı (KOAH) ve ateroskleroz benzer risk faktörlerine bağlı olarak meydana gelebilmek- te olup, önemli oranda morbidite ve mortaliteye neden olmaktadır. Bu çalışmada KOAH ve ateroskleroz arasındaki ilişkinin değerlendirilmesi için KOAH’lı ve aterosklerotik risk faktörü olmayan, normal beden kitle indeksi ve metabolik parametrele- re sahip erişkin sağlıklı bireylerin karotis intima mediya kalınlıkları (KİMK)’nın karşılaştırılması amaçlanmıştır. Materyal ve Metod: Yaşları 18-92 arasında değişen 2298 katılımcıyla yapılan çalışmamızda, solunum fonksiyon testi ve kli- nik özelliklerine göre KOAH tanısı konulan 46 hasta ile dışlama kriterini taşımayan 47 sağlıklı birey değerlendirildi. Katı- lımcılara KİMK değerlendirmesi için doppler ultrasonografi incelemesi yapıldı. İstatistiksel olarak p< 0.05 anlamlı kabul edil- di. Bulgular: Ortalama KİMK KOAH grubunda 0.79 ± 0.16 mm; kontrol grubunda 0.616 ± 0.1 mm olarak ölçüldü (p< 0.001). KİMK’yi etkileyen aterosklerotik parametrenin tayini için yapılan çoklu lineer regresyon analizinde KİMK’nin yaş ile anlam- lı bir şekilde doğru orantılı (p= 0.002), FEV1% ile de anlamlı bir şekilde ters orantılı (p= 0.04) olduğu saptandı. KİMK değe- rine göre ateroskleroz tanısı konulan hastalarımızda ateroskleroza hangi parametrenin en fazla katkı sağladığını bulmak için yapılan multivaryant lojistik regresyon analizinde ateroskleroz ile ilişkili parametre bulamadık. Sonuç: KOAH ve aterosklerotik hastalıklarda bulunan kalıcı düşük dereceli sistemik inflamasyon varlığının, muhtemelen her iki patolojiyi de yürüten faktör olabileceği bildirilmiştir. KOAH tanılı erişkinlerde erken dönem ateroskleroz ve kardiyo- vasküler riski, diğer risk faktörlerinden bağımsız olarak artmakta olup girişimsel olmayan, kolay uygulanabilir ve ucuz bir tanı yöntemi olarak risk tayininde kullanılabilen KİMK yaş ile doğru FEV1% ile ters orantılı olarak artış göstermektedir.

Evaluation of carotis intima media thickness in chronic obstructive pulmonary disease patients

ntroduction: Chronic obstructive pulmonary disease (COPD) and atherosclerosis may occur due to similar risk factors and have a significant cause of morbidity and mortality. In this study to assess the relationship between COPD and atheroscle- rosis; carotid intima media thickness (CIMT) of COPD patients and adult healthy individuals with normal body mass index and metabolic parameters compared. Materials and Methods: 2298 participants aged between 18-92; 46 patients diagnosed with COPD according to clinical fe- atures and pulmonary function tests the study, 47 healthy controls who do not have exclusion criteria were evaluated. Doppler ultrasound was performed for the assessment of CIMT to all participants. p values < 0.05 were considered to be sig- nificant. Results: Mean CIMT in COPD group and control group were 0.79 ± 0.16 mm and 0.616 ± 0.1 mm, respectively (p< 0.001). In multiple linear regression analysis that made to determine the atherosclerotic risk parameters affecting CIMT; it was fo- und that CIMT was related to age with direct proportion (p= 0.002) and to FEV1% with inversely proportion (p= 0.04). In multivariate logistic regression analysis that made to determine the parameters affecting atherosclerosis; we found that any parameters were related with atherosclerosis. Conclusion: Persistent low-grade systemic inflammation in COPD and atherosclerotic disease may possibly have been re- ported a factor in both pathologies. Early atherosclerosis and cardiovascular risks in adults with COPD increase indepen- dent of risk factors. CIMT which shows direct proportion with age and inverse proportion with FEV1% is a non-invasive, ea- sily applicable and cheap method that can be used in determining the risk of atherosclerosis.

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