Mehmet Yavuz GÜRLER, Umut HAKLIGİL, Fatih BORLU, Ekmel Burak ÖZŞENEL, Güzin KARATEMİZ, Emrah Erkan MAZI, Seyit UYAR, Fergial MOUEMINOGLU

Sitagliptin tedavisinin total antioksidan kapasite ve kan şekeri üzerine etkileri

Amaç: Diyabette antioksidan özelliğ i olan bazı ilaçlar ı n tedaviye eklenmesi, kan ş ekeri regülasyonu yan ı nda serbest radikallerin etkisiyle ba ş a ç ı kabilmede fayda sa ğ layabilir. Çal ı ş mam ı zda, tip 2 diyabet tedavisinde bir dipeptidilpeptidaz 4 inhibitörü olan sitagliptinin kan ş ekeri regüle edici etkisi yan ı nda antioksidan özelliğ i bulunup bulunmad ı ğ ı n ı , total anti oksidan kapasite (TAOK) ölçerek tespit edilmeye çal ı ş tı k. Materyal ve Metot: Bir yı l içinde hastanemizin iç hasta- l ı kları polikliniğ ine ba ş vuran, tip 2 diyabet te şhisi alm ı ş , kriterlere uygun 100 hasta çal ı ş maya al ı nd ı . Endikasyon dahilinde random olarak 50 hastaya sitagliptin ba ş land ı . Diğ er 50 hasta kontrol gurubu olarak tayin edildi. Hastalardan çal ı ş maya ba ş lanmadan önce ve üç ay sonra kan al ı nd ı . Toplam 80 hasta çal ı ş mayı tamamlad ı . TAOK, RelAssayDiagnostik ®e ait kit kullan ı larak kalorimetrik yöntemle çal ı şı ld ı . Bulgular: Vaka grubu (p= 0,076) ve kontrol grubu (p= 0,076) birinci ve ikinci TAOK ölçümleri aras ı nda anlaml ı fark tespit edilemedi. Vaka grubu HbA1c birinci ölçüm ortalamas ı ile vaka grubu HbA1c ikinci ölçüm ortalamas ı arası nda istatistiksel olarak anlaml ı farkl ı l ı k bulundu. Kontrol grubu HbA1c birinci ölçüm ortalaması ile kontrol grubu HbA1c ikinci ölçüm ortalaması aras ı nda istatistiksel anlaml ı fark yoktu (p= 0,091). Sonuçlar: HbA1c de ğ erinde anlaml ı oranda dü ş me izlenmesi kan ş ekeri regülasyonu ve komplikasyon geliş me riski aç ı s ı ndan oldukça önemlidir. Oksidatif stresin azalt ı lmas ı antioksidan kapasitenin arttı r ı lmas ı diyabet tedavisi aç ı sı ndan oldukça önemlidir. Üç ayl ı k sitagliptin tedavisinin direkt olarak TAOKu etkilemediğ ini anlad ı k; ancak 3 aydan daha ileriye uzatı lacak çal ı ş malarda TAOK rezervinin hipergliseminin yapaca ğ ı oksidatif stresi azaltarak dolayl ı yoldan korudu ğ unu görmek mümkün olabilir.

Effect of sitagliptin therapy on antioxidant capacity and blood sugar level

Background: During diabetes therapy, adding some drugs which have antioxidant feature help us to deal with free radical side effects while regulating the blood glucose level. We investigate sitagliptin, a dipeptidyl peptidase-4 inhibitor used in type 2 diabetes therapy. Blood glucose regulating capacity is measured by HbA1 c level and total anti-oxidant capacity (TAOC) is measured to find out if there is an antioxidant feature. Materials and Methods: One hundred patients with type 2 diabetes who fit the inclusion criteria and applied to internal medicine inpatient clinic were enrolled to the study. Sitagliptin is added to 50 patients therapy randomly within indications. Other 50 were chosen as control group. The blood was taken before study and after three months. Eighty patients finished the study. RelAssayDiagnostik® kit is used to measure TAOC which is a calorimetric assay. Results: When we compared both case (p= 0,076) and control (p= 0,076) groups for the first and second TAOK measures, there were no significant difference. Case groups first measure of HbA1c averages and case groups second measure of HbA1c averages were significantly different. Control groups first measure of HbA1c averages and control groups second measure of HbA1c averages were not significantly different (p= 0.091). Conclusions: Significant decrease of HbA1c levels are important in blood glucose regulation and development of complications. We understood that TAOC is not directly affected by sitagliptin treatment for three months. If we elongate study for more than 3 months we may see that TAOC reserves are protected indirectly by the decreasing hyperglycemia causing oxidative stress.

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