Koroner arter hastalığı için aile öyküsü pozitif olan bireylerde asimetrik dimetilarjinin düzeylerinin geleneksel risk puanlama yöntemleri ile ilişkisi
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Tarih
2011
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Koroner arter hastalığı (KAH) Dünyada ve Türkiye’de en sık ölüm nedenidir. Asimetrik dimetilarjinin insanda nitrik oksit biyosentezinin majör inhibitörüdür. Yapılan çalışmalarda plazma asimetrik dimetilarjinin (ADMA) düzeylerindeki artışın endotel disfonksiyonu ve artmış aterogenez ile ilişkili olduğu gösterilmiştir. Bu çalışmada asimetrik dimetilarjinin düzeylerinin koroner arter hastalığı aile öyküsü olan sağlıklı bireylerde mevcut risk belirleme yöntemleri ile ilişkisi araştırılmıştır. Yöntemler: Enine-kesitli gözlemsel olarak tasarlanan bu çalışmaya birinci derece yakınları erken yaşta miyokart enfarktüsü geçiren, yaşları 20-40 arasında olan 52 birey ile kontrol grubu olarak benzer yaş grubunda 26 sağlıklı birey alınmıştır. Çalışmaya alınan deneklerin sigara, diyabet, hiperlipidemi gibi klasik, homosistein ve C-reaktif protein (CRP) gibi biyokimyasal risk faktörleri; Framingham ve TEKHARF risk skorları ve serum asimetrik dimetilarjinin seviyeleri arasındaki ilişki kategorik değişkenler için Ki-kare, sürekli değişkenler için Mann-Whitney U testi ile karşılaştırıldı. Bulgular: Yapılan değerlendirme sonunda KAH açısından riskli bireylerin ortalama açlık kan şekeri, trigliserit, yüksek-dansiteli lipoprotein, diyastolik kan basıncı, bel çevresi, TEKHARF risk skoru kontrol grubundan yüksekti. Total kolesterol, düşük-dansiteli lipoprotein, CRP, homosistein, kreatinin, Framingham risk skoru değerleri gruplar arasında benzer bulundu. Asimetrik dimetilarjinin değerleri risk grubunda ortalama 0.1 µmol/L daha yüksek bulunsa da, bu fark istatistiksel olarak anlamlılığa ulaşmadı (0.70.1 µmol/l’e karşılık 0.80.1 µmol/l; p0.061). Sonuç: Asimetrik dimetilarjinin düzeyinin aile öyküsü pozitif olan bireylerde mevcut risk belirleme yöntemlerine ek fayda sağladığı gösterilememiştir. Bu konuda değişik risk gruplarına ait daha fazla sayıda olgu ile yapılacak çalışmalara ihtiyaç vardır.
Objective: Coronary artery disease is the most common cause of death in Turkey and the world. Asymmetric dimethylarginine is the major inhibitor of nitric oxide synthesis in humans. It has been shown that increased levels of asymmetric dimethylarginine is associated with endothelial dysfunction and increased atherogenesis. In this study, we aimed to investigate whether asymmetric dimethylarginine level is related with conventional risk score systems in subjects who had family history of coronary artery disease. Methods: Fifty two subjects within 20-40 years old of whom first degree relatives had myocardial infarction at young ages and 26 age and sex matched control subjects were included in this cross-sectional observational study. Frequency of diabetes, hyperlipidemia, smoking and serum levels of homocysteine, high-sensitive C-reactive protein (hsCRP) and asymmetric dimethylarginine were compared between risk group and control subjects. Relation of asymmetric dimethylarginine level with Framingham and TEKHARF risk scores was also compared. Chi-square and Mann-Whitney U tests were used to compare categorical and continuous variables, respectively. Results: Fasting serum glucose, triglyceride, high-density lipoprotein, diastolic blood pressure, waist circumference and TEKHARF scores were increased in the subjects who had family history of myocardial infarction. Total cholesterol, low-density lipoprotein, hsCRP, homocysteine, creatinine and Framingham risk score were similar in studied groups . Asymmetric dimethylarginine levels were 0.1µmol/L higher in the risk group; however this difference could not reach significance (0.7±0.1 µmol/l vs 0.8±0.1 µmol/l; p0.061). Conclusion: Measurement of serum asymmetric dimethylarginine levels did not reveal utility in defining conventional coronary artery disease risk score systems in cases that had positive family history. Larger studies including patients with different risk tertiles are needed.
Objective: Coronary artery disease is the most common cause of death in Turkey and the world. Asymmetric dimethylarginine is the major inhibitor of nitric oxide synthesis in humans. It has been shown that increased levels of asymmetric dimethylarginine is associated with endothelial dysfunction and increased atherogenesis. In this study, we aimed to investigate whether asymmetric dimethylarginine level is related with conventional risk score systems in subjects who had family history of coronary artery disease. Methods: Fifty two subjects within 20-40 years old of whom first degree relatives had myocardial infarction at young ages and 26 age and sex matched control subjects were included in this cross-sectional observational study. Frequency of diabetes, hyperlipidemia, smoking and serum levels of homocysteine, high-sensitive C-reactive protein (hsCRP) and asymmetric dimethylarginine were compared between risk group and control subjects. Relation of asymmetric dimethylarginine level with Framingham and TEKHARF risk scores was also compared. Chi-square and Mann-Whitney U tests were used to compare categorical and continuous variables, respectively. Results: Fasting serum glucose, triglyceride, high-density lipoprotein, diastolic blood pressure, waist circumference and TEKHARF scores were increased in the subjects who had family history of myocardial infarction. Total cholesterol, low-density lipoprotein, hsCRP, homocysteine, creatinine and Framingham risk score were similar in studied groups . Asymmetric dimethylarginine levels were 0.1µmol/L higher in the risk group; however this difference could not reach significance (0.7±0.1 µmol/l vs 0.8±0.1 µmol/l; p0.061). Conclusion: Measurement of serum asymmetric dimethylarginine levels did not reveal utility in defining conventional coronary artery disease risk score systems in cases that had positive family history. Larger studies including patients with different risk tertiles are needed.
Açıklama
Anahtar Kelimeler
Kalp ve Kalp Damar Sistemi
Kaynak
Anadolu Kardiyoloji Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
11
Sayı
2
