Safra Taşı Hastalığının Serum RBP4 Düzeyi, D Vitamini, Lipid Profili, İnsülin Direnci ve Ürik Asit Düzeyleri ile İlişkisi

Yıl 2024, Cilt: 6 Sayı: 2, 161 - 169, 30.06.2024

Bediz Kurt İnci , Kamil İnci , Özge Paşaoğlu , Hatice Pasaoglu , Gıyasettin Şükrü Dumlu

https://doi.org/10.52827/hititmedj.1424453

Öz

Amaç: Safra taşları ile ilişkilendirilen metabolik parametreler birçok çalışmanın konusunu oluşturmaktadır. RBP4, bir adipokin olup metabolik hastalıklarla ilişkilendirilmiştir; ancak bildiğimiz dahilinde, safra taşı hastalığı ile ilişkisini belirleyen bir çalışma bulunmamaktadır. Çalışmamızda, öncelikle serum RBP4 olmak üzere safra taşı ile ilişkilendirilen biyokimyasal parametreleri değerlendirmeyi amaçladık.
Gereç ve Yöntem: 2015-2016 yılları arasında gastroenteroloji kliniğine başvuran 80 hastanın abdominal ultrason, serum biyokimyasal testler, lipid profilleri, ürik asit, insulin ve açlık glukoz değerleri mevcuttu ve çalışmaya dahil edildi. RBP4 seviyeleri, alınan serum örneklerinde analiz edildi.
Bulgular: Seksen hastanın 42’sinde safra taşı bulunurken, 38’inde yoktu. Biyokimyasal parametreler arasında, toplam kolesterol değerleri (p= 0.483), LDL değerleri (p=0.224) ve trigliserit değerleri (p=0.764) açısından gruplar arasında anlamlı fark bulunmamıştır. İki grup arasında HDL değerleri açısından anlamlı fark gözlemlenmiştir (p=0.017). Serum ürik asit (p=0.411), açlık glukozu (p=0.214), açlık insulin ve HOMA-IR skoru (p=0.157), vitamin D seviyeleri (p=0.340) açısından iki grup arasında anlamlı fark bulunmamıştır. Çalışmaya katılan kişilerin incelenen serum RBP4 seviyelerinin ortalama±SD değerleri kontrol grubunda 40,24±7,12, hasta grubunda ise 39,75±8,55 olarak belirlenmiştir. İki grup arasında anlamlı fark bulunmamıştır (p=0.776). Korelasyon analizlerinde; RBP4 ile vitamin D seviyeleri (r: 0.277, p= 0.013), toplam kolesterol (r: 0.268, p=0.016), trigliserit (r: 0.387, p<0.001), GGT (r: 0.294, p=0.008), AST (r: 0.299, p=0.007) ve ürik asit (r: 0.255, p=0.022) arasında anlamlı pozitif korelasyon bulunmuştur.
Sonuç: Sonuç olarak, çalışmamızda safra kesesi taşları ile RBP4, vitamin D, LDL, TG, toplam kolesterol, ürik asit ve HOMA-IR arasında anlamlı ilişki bulunamamıştır. Ancak çalışmamızda saptanan D vitamin ve RBP4 düzeyi arasındaki pozitif korelasyonun gelecekteki çalışmalar için yol gösterici olduğu düşünülmüştür.

Anahtar Kelimeler

Kolelitiazis, RBP4, Safra Taşı Hastalığı

Etik Beyan

Hastanın Gazi Ünivestesi Tıp Fakültesinden alınan 26.5.2014 tarihli etik kurul onam belgesi ek dosya olarak ana makale metini ile yüklenmiştir sunulmuştur.

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

yok

The Relationship of Gallestone Disease with Serum RBP4 Level, Vitamın D, Lipid Profile, Insulin Resistance and Uric Acid Levels

Öz

Objective: The metabolic parameters associated with gallstones are the subject of numerous studies. RBP4, an adipokine, has been linked to various metabolic diseases; however, no study in the literature establishes its relationship with gallstone disease. Therefore, our study aimed to evaluate the biochemical parameters associated with gallstone disease, primarily serum RBP4.
Material and Method: Between 2015 and 2016, abdominal ultrasound, serum biochemical tests, lipid profiles, uric acid, insulin, and fasting glucose values were available for 80 patients who presented to our hospital’s gastroenterology clinic, were included in the study. RBP4 levels were analyzed in the serum samples obtained from the patients.
Results: Out of the 80 participants in the study, 42 had gallstones, while 38 did not. Among the biochemical parameters, no significant difference was found between the groups in terms of total cholesterol values (p= 0.483), LDL values (p=0.224), and TG values (p=0.764). A significant difference was observed between the two groups regarding HDL values(p=0.017). No significant difference was found between the two groups in terms of serum uric acid (p=0.411), fasting glucose (p=0.214), fasting insulin, HOMA-IR score (p=0.157), and vitamin D levels (p=0.340). The mean±SD values of the studied serum RBP-4 levels in the participants were determined as 40.24±7.12 in the control group and 39.75±8.55 in the patient group. No statistically significant difference was found between the two groups (p=0.776). In correlation analyses, a significant positive correlation was found between RBP4 and vitamin D levels (r: 0.277, p= 0.013), total cholesterol (r: 0.268, p=0.016), triglycerides (r: 0.387, p<0.001), GGT (r: 0.294, p=0.008), AST (r: 0.299, p=0.007), and uric acid (r: 0.255, p=0.022).
Conclusion: In conclusion, our study did not find a statistically significant relationship between gallstones and RBP4, vitamin D, LDL, TG, total cholesterol, uric acid, and HOMA-IR. However, our study found a positive correlation between vitamin D levels and RBP4. This has guided future research.

Anahtar Kelimeler

Cholelithiasis, Gallstone Disease, RBP4

Proje Numarası

yok

Kaynakça

• Everhart JE, Khare M, Hill M, Maurer KR. Prevalence and ethnic differences in gallbladder disease in the United States. Gastroenterology. 1999;117(3):632-639.
• Polson DA, Thompson MP. Macronutrient composition of the diet differentially affects leptin and adiponutrin mRNA expression in response to meal feeding. The Journal of Nutritional Biochemistry 2004;15(4):242-246.
• Antuna-Puente B, Feve B, Fellahi S, Bastard J-P. Adipokines: the missing link between insulin resistance and obesity. Diabetes & metabolism 2008;34(1):2-11.
• Perumalsamy S, Ahmad WAW, Huri HZ. Retinol-Binding Protein-4A Predictor of Insulin Resistance and the Severity of Coronary Artery Disease in Type 2 Diabetes Patients with Coronary Artery Disease. Biology 2021;10(9):858.
• Olsen T, Blomhoff R. Retinol, retinoic acid, and retinol-binding protein 4 are differentially associated with cardiovascular disease, type 2 diabetes, and obesity: an overview of human studies. Advances in Nutrition 2020;11(3):644-666.
• Zdanowicz K, Ryzko J, Bobrus‐Chociej A, Wojtkowska M, Lebensztejn DM. The role of chemerin in the pathogenesis of cholelithiasis in children and adolescents. Journal of Paediatrics and Child Health 2021;57(3):371-375.
• Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the international diabetes federation task force on epidemiology and prevention; national heart, lung, and blood institute; American heart association; world heart federation; international atherosclerosis society; and international association for the study of obesity. Circulation 2009;120(16):1640-1645.
• Kaur J. A comprehensive review on metabolic syndrome. Cardiology research and practice 2014;2014: 943162.
• Zhu Q, Sun X, Ji X, et al. The association between gallstones and metabolic syndrome in urban Han Chinese: a longitudinal cohort study. Scientific reports 2016;6(1):29937.
• Lin I, Yang YW, Wu MF, et al. The association of metabolic syndrome and its factors with gallstone disease. BMC family practice 2014;15(1):1-6.
• Cândido FG, Bressan J. Vitamin D: link between osteoporosis, obesity, and diabetes? International journal of molecular sciences 2014;15(4):6569-6591.
• Onal ED, Berker D, Guler S. Vitamin D deficiency and gallbladder stasis. Digestive diseases and sciences 2015;60:3823-3824.
• Loria P, Lonardo A, Lombardini S, et al. Gallstone disease in non‐alcoholic fatty liver: prevalence and associated factors. Journal of gastroenterology and hepatology 2005;20(8):1176- 1184.
• Wang SN, Yeh YT, Wang ST, et al. Decreased retinol binding protein 4 concentrations are associated with cholesterol gallstone disease. Journal of the Formosan Medical Association 2010;109(6):422-429.
• Faul F, Erdfelder E, Lang A-G, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research methods 2007;39(2):175-191.
• Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut and liver 2012;6(2):172.
• Völzke H, Baumeister SE, Alte D, et al. Independent risk factors for gallstone formation in a region with high cholelithiasis prevalence. Digestion 2005;71(2):97-105.
• Shrestha K, Dahal P, Shah L, Singh R. Relation of lipid profile, BMI and cholelithiasis in Nepalese population. Postgraduate medical journal of National Academy of Medical Sciences 2012;12:40-44.
• Einarsson K, Nilsell K, Leijd B, Angelin B. Influence of age on secretion of cholesterol and synthesis of bile acids by the liver. New England Journal of Medicine 1985;313(5):277-282.
• Maurer KR, Everhart JE, Ezzati TM, et al. Prevalence of gallstone disease in Hispanic populations in the United States. Gastroenterology 1989;96(2):487-492.
• Sekine K, Nagata N, Sakamoto K, et al. Abdominal visceral fat accumulation measured by computed tomography associated with an increased risk of gallstone disease. Journal of gastroenterology and hepatology 2015;30(8):1325-1331.
• Tazuma S, Kanno K, Kubota K, et al. Report on the 2013 national cholelithiasis survey in Japan. Journal of Hepato‐ Biliary‐Pancreatic Sciences 2015;22(5):392-395.
• Chen LY, Qiao QH, Zhang SC, Chen YH, Chao GQ, Fang LZ. Metabolic syndrome and gallstone disease. World journal of gastroenterology 2012;18(31):4215.
• McTernan PG, Kumar S. Retinol binding protein 4 and pathogenesis of diabetes. Oxford University Press; 2007. p. 2430-2432.
• Han T, Zhang D, Fu Z, Sun Y, Yang W, Yuan C. Retinol-binding protein 4 as a risk factor for cholesterol gallstone formation. Molecular and cellular biochemistry 2013;377:219-227.
• Atamanalp SS, Keles MS, Atamanalp RS, Acemoglu H, Laloglu E. The effects of serum cholesterol, LDL, and HDL levels on gallstone cholesterol concentration. Pakistan journal of medical sciences 2013;29(1):187.
• Olokoba A, Bojuwoye B, Katibi I, et al. Relationship between gallstone disease and serum lipids in normal adult Nigerians. African Scientist 2021;7(3):113-116.
• Song ST, Shi J, Wang XH, et al. Prevalence and risk factors for gallstone disease: A population‐based cross‐sectional study. Journal of digestive diseases 2020;21(4):237-245.
• Stender S, Frikke-Schmidt R, Benn M, Nordestgaard BG, Tybjærg-Hansen A. Low-density lipoprotein cholesterol and risk of gallstone disease: a Mendelian randomization study and meta-analyses. Journal of hepatology 2013;58(1):126-133.
• Atamer A, Kurdas-Ovunc AO, Yesil A, Atamer Y. Evaluation of paraoxonase, malondialdehyde, and lipoprotein levels in patients with asymptomatic cholelithiasis. Saudi journal of gastroenterology: official journal of the Saudi Gastroenterology Association 2014;20(1):66.
• Smelt A. Triglycerides and gallstone formation. Clinica chimica acta 2010;411(21-22):1625-1631.
• Atamer A, Övünç AOK, Yeşil A, Atamer Y. Evaluation of leptin and insulin resistance in patients with cholelithiasis. Indian Journal of Biochemistry and Biophysics 2013; 50(4):266-272
• Kim SS, Lee JG, Kim DW, et al. Insulin resistance as a risk factor for gallbladder stone formation in Korean postmenopausal women. The Korean journal of internal medicine 2011;26(3):285.
• Shebl F, Andreotti G, Meyer T, et al. Metabolic syndrome and insulin resistance in relation to biliary tract cancer and stone risks: a population-based study in Shanghai, China. British journal of cancer 2011;105(9):1424-1429.
• Hung MC, Chen CF, Tsou MT, Lin HH, Hwang LC, Hsu CP. Relationship between gallstone disease and cardiometabolic risk factors in elderly people with non-alcoholic fatty liver disease. Diabetes, Metabolic Syndrome and Obesity 2020;13:3579-3585.
• Chen CH, Huang MH, Yang JC, et al. Prevalence and risk factors of gallstone disease in an adult population of Taiwan: an epidemiological survey. Journal of gastroenterology and hepatology 2006;21(11):1737-1743.
• Martens P-J, Gysemans C, Verstuyf A, Mathieu C. Vitamin D’s effect on immune function. Nutrients 2020;12(5):1248.
• Karampela I, Sakelliou A, Vallianou N, Christodoulatos G-S, Magkos F, Dalamaga M. Vitamin D and obesity: current evidence and controversies. Current obesity reports 2021;10:162-180.