Hemoglobinopati, Asetil Salisilik Asit Kullanimi Ve Üreminin İmmünoturbidimetrik Ve HPLC Hemoglobin A1c Ölçümleri Üzerine Etkileri

Year 2019, Volume: 6 Issue: 3, 142 - 147, 30.09.2019

Gülçin Şahingöz Erdal , Murat Koşer Pınar Kasapoğlu , Nilgün Işıksaçan

https://doi.org/10.34087/cbusbed.558634

Abstract

Amaç: Tip II Diabetes
Mellitus (T2DM) en sık endokrin hastalıktır. Yüksek glikolize hemoglobin
(HbA1c) düzeylerinin kardiyovasküler hastalıklarda (KVH) risk faktörü olduğu ve
KVH'ların da diyabetik hastalarda ölüm ve sakatlığa neden olduğu bilinmektedir.
HbA1c düzeylerinin doğru ölçülmesi, hastaların tanı ve tedavi süreçlerinin
değerlendirilmesinde son derece önemli rol oynamaktadır.

 

Ülkemizde başta talasemi minör olmak üzere hemoglobin varyantları
yaygın olarak görülmektedir. Diyabetin kardiyovasküler etkileri nedeniyle de
asetilsalisilikasit (ASA) sıklıkla diyabetik hastalar tarafından
kullanılmaktadır. Diyabetik nefropati ise son dönemde hemodiyaliz gerektiren
böbrek yetmezliğine ve üremiye neden olmaktadır. Bu çalışmada
immünoturbidimetri ve yüksek performanslı sıvı kromatografi (HPLC)
yöntemlerinin 3 hasta grubunda HbA1c düzeylerini ölçmek üzere karşılaştırılması
amaçlanmıştır.

 

Gereç-Yöntem: Bu çalışmaya her biri 20
hastadan oluşan üç grup dahil edilmiştir. Bu çalışmaya 20’şer kişilik 3 hasta
grubu dahil edilmiştir. İlk grup hemoglobin elektroforezi kullanılarak
“hemoglobinopati” tanısı alan hastalardan, ikinci grup en az 6 aydır günde 100
mg veya üzerinde ASA alan hastalardan ve üçüncü grup  kronik hemodiyalize giren hastalardan
oluşmaktadır. Hastalardan alınan EDTA içeren tüplere toplanan venöz kan
örnekleri,  Premier Hb 9210 (Trinity
Biotech –USA) ve Cobas c501 (Roche –Almanya) cihazları kullanılarak analiz
edilmiştir.

 

Sonuç: Her 3 grupta immünoturbidimetri ile
HPLC yöntemi karşılaştırıldığında grupların içinde HbA1c düzeyleri arasında
anlamlı bir istatistiksel fark bulunamamıştır (p=0,462, p=0,065 p=0,062).

 

Tartışma: İmmünoturbidimetri ve HPLC,
HbA1c ölçümlerinde yaygın olarak kullanılan yöntemlerdendir.  İmmünoturbidimetrik yöntemin HbA1c
ölçümlerinde HPLC yöntemi ile arasında güçlü bir korelasyon olduğu
gösterilmiştir. HbA1c analizini etkileyebilecek 
hastalıklar ve ilaçlar göz önünde bulundurulmalıdır.

 

Keywords

HbA1c, HPLC, immünoturbidimetri, hemoglobinopati, üremi

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