Kronik Böbrek Hastalığı Olan Tip 2 Diyabetli Hastalarda Aortik Yayılım Hızı ile Subklinik Aterosklerozun Değerlendirilmesi

Yıl 2016, Cilt: 19 Sayı: 3, 167 - 172, 01.12.2016

Mehmet Yaman , Türkan Mete İsmail Özer Yasemin Kaya Ahmet Karataş

Öz

Giriş:
Diabetes mellitus (DM) ve kronik böbrek hastalığı
(KBH) aterosklerozu hızlandırmaktadır. Klinik sonuçları iyileştirmek için,
aterosklerozu değerlendiren ve izleyen invaziv olmayan görüntüleme yöntemleri
geliştirilmektedir. Son zamanlarda, inen torasik aortun renkli M-mod yayılım
hızının [aortik yayılım hızı (AYH)] koroner ve karotisaterosklerozu ile
ilişkili olduğu gösterilmiştir.

Hastalar
ve Yöntem: Çalışma popülasyonu KBH olan
tip 2 diyabetli 90 hasta (grup 1) ve yaş ve cinsiyet benzer, normal böbrek
fonksiyonlarına sahip tip 2 diyabetli 40 hastadan (grup 2) oluşmaktaydı.
Karotis intima-media kalınlığı (KİMK) ve AYH ölçüldü. Bilinen koroner kalp
hastalığı veya son dönem böbrek yetmezliği olan hastalar çalışmaya dahil
edilmedi.

Bulgular:
Grup 2 ile karşılaştırıldığında, grup 1 hastalar
daha düşük AYH düzeylerine (grup 1= 29.85 ± 3.95 cm/sn ve grup 2= 41.05 ± 3.34
cm/s, p< 0.001) ve daha yüksek KİMK düzeylerine (grup 1= 1.06 ± 0.11 mm ve
grup 2= 0.78 ± 0.10 mm, p< 0.001) sahipti. AYH ve KİMK arasında anlamlı
korelasyon mevcuttu (r= -0.669, p< 0.001).

Sonuç:
KBH
olan diyabetli hastalar, normal böbrek fonksiyonlu diyabetli hastalara göre
daha belirgin AYH ve KIMK değerleri ile belirlenen daha fazla subklinik ateroskleroza
sahiptir. Bu basit metodlar, aterosklerozun progresyonunun primer önlenmesi
için hasta seçimini geliştirebilir.

Anahtar Kelimeler

Aortik yayılım hızı, karotis intima-media kalınlığı, tip 2 diabetes mellitus, kronik böbrek hastalığı, ateroskleroz

Assessment of Subclinical Atherosclerosis with Aortic Velocity Propagation in Patients with Type 2 Diabetes and Chronic Kidney Disease

Öz

Introduction:
Diabetes mellitus (DM) and chronic kidney disease
(CKD) accelerate the process of atherosclerosis. To improve clinical outcomes,
non-invasive imaging modalities have been proposed to measure and monitor
atherosclerosis. Recently, colour M-mode-derived propagation velocity of the
descending thoracic aorta [aortic velocity propagation (AVP)] has been shown to
be associated with coronary and carotid atherosclerosis.

Patients
and Methods: The study population included 90 patients
with type 2 diabetes who had CKD (Group 1) and 40 age- and sex-matched patients
with type 2 diabetes who had a normal renal function (Group 2). Carotid
intima-media thickness (CIMT) and AVP were measured. Patients with known
coronary heart disease or end-stage renal disease were excluded.

Results:
Compared with Group 1, patients in Group 2 had
significantly lower AVP (Group 1=  29.85
± 3.95 cm/s and Group 2= 41.05 ± 3.34 cm/s, p< 0.001) and higher CIMT (Group
1= 1.06 ± 0.11 mm and Group 2= 0.78 ± 0.10 mm, p< 0.001). There were
significant correlations between AVP and CIMT (r= -0.669, p< 0.001).

Conclusion:
Patients
with diabetes who have CKD exhibit more subclinical atherosclerosis, which is
determined by more prominent AVP and CMIT, than patients with diabetes who have
a normal renal function. These simple methods might improve patient selection
for the prevention of primary atherosclerotic progression.

Anahtar Kelimeler

Aortic velocity propagation, carotid intima-media thickness, type 2 diabetes, chronic kidney disease, atherosclerosis

Kaynakça

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