Diyabetik retinopatisi olan hastalarda total antioksidantstatus ve total oksidant status düzeylerinin incelenmesi
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Date
2022
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Düzce Üniversitesi
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info:eu-repo/semantics/openAccess
Abstract
Amaç: Diyabetik retinopati, diyabetin en yaygın görülen mikrovasküler komplikasyonudur. Retinopatinin patogenezinde birçok mekanizma tanımlanmıştır. Oksidatif stres diyabetik retinopati gelişiminde önemli bir rol oynamaktadır. Bu çalışmada oksidatif stresin belirteçleri olarak total antioksidant status (TAS), total oksidant status (TOS) ve oksidatif stres indexi (OSİ) düzeylerinin diyabetik retinopati patogenezindeki rolünü, retinopati erken tanı ve tedavisindeki yerini araştırmayı amaçladık. Gereç ve Yöntem: Düzce Üniversitesi Tıp Fakültesi Hastanesi İç Hastalıkları ve Göz Hastalıkları polikliniğine Mayıs 2021-Aralık 2021 tarihleri arasında başvuran 18-75 yaş arası diyabetik retinopatisi olan 30 hasta, diyabetik olup retinopatisi olmayan 34 hasta ve bilinen kronik hastalık tanısı olmayan sağlıklı 32 kontrol grubu dahil edildi. Hastaların demografik verileri muayene sırasında kaydedildi. Katılımcılar göz hastalıkları polikliniğinde Optik Koherens Tomografi (OCT) kullanılarak tarandı. Hemogram ve biyokimyasal parametreler için yazılı ya da elektronik kayıtlara geçen hastaların rutin poliklinik kontrollerindeki sonuçlarından yararlanıldı. TAS, TOS ölçümleri MINDRAY-BS400 marka cihazda RelAssay Diagnonostics marka ticari kitlere kalibrasyon-kontrol işlemlerinden sonra kolorimetrik yöntemle analiz edildi. Sonuçlar TAS mmol/L, TOS µmol/L cinsinden verildi. TOS/TAS oranı ile OSİ değeri hesaplandı. Elde edilen tüm veriler SPSS 26.0 istatistik paket programı kullanılarak değerlendirildi. Bulgular: Çalışmaya toplam 96 hasta kabul edilmiştir. Gruplar arasında cinsiyet dağılımı, medeni durum, vücut kitle indexi, bel ve kalça çevresi benzer izlendi. Diyabet süresi, HbA1C, açlık kan şekeri, proteinüri ve trigliserid düzeyleri diyabetik retinopatisi olan grupta yüksek saptandı. TOS ölçümleri, retinopatisi olan grupta ortalama 8.11 ± 2.87 µmol/L, retinopatisi olmayan grupta µmol/L 5.72 ±1.44 ve kontrol grubunda 4.69 ± 1.40 µmol/L ile en düşük kontrol grubunda saptanırken retinopatili hasta grubunda istatiksel olarak anlamlı yüksek bulundu (p:0.000). TAS, kontrol grubunda 1.26 ± 0.20 mmol/L ile anlamlı yüksek, diyabetik hasta grubunda düşük saptandı. Retinopatisi olan grupta 1.09 ± 0.171 mmol/L, retinopatisi olmayan grupta 1.16 ±. 0.18 mmol/L olarak düşük bulundu ancak istatiksel olarak anlamlı bulunmadı (p:0.139). OSİ değeri DRP'li grupta 0.76 ± 0.29 bulundu ve TOS değeri ile uyumlu olup yüksek saptandı (p:0.000). TOS ve OSİ düzeyleriyle Açlık kan şekeri, HbA1C, TSH, trigliserid arasında pozitif yönde korelasyon izlendi. Diyabetik retinopatiyi öngörmek için yapılan multivariate logistik regresyon analizinde diyabet süresi, toplam insülin dozu ve diüretik kullanımının olması, TOS ve OSİ düzeylerinin yüksek olması diyabetik retinopati için bağımsız bir risk olarak saptamıştır. Sonuç: Çalışmamızda diyabetik vakalar ve sağlıklı kontrol gruplarının karşılaştırılmasıyla; TAS seviyelerindeki düşüklüğün diyabetin kendisi ile yakın ilişkili olduğu ancak retinopatiyi göstermede yetersiz kaldığını gösterilmiştir. TOS ve OSİ ölçümleri diyabetik retinopati gelişimini ön görmede yüksek duyarlılık ve özgüllüğe sahiptir. Oksidan ve antioksidan arasındaki dengenin bozulması, oksidatif stresin diyabetik retinopati etyopatogenezinde önemli bir rol oynadığı gösterilmiştir. TOS ve OSİ düzeylerinin kalorimetrik ölçümleri diyabetik retinopati erkan tanısı, tedavisi ve takibine katkı sağlayabilir. Ancak bu alanda daha büyük çaplı prospektif çalışmalara ihtiyaç vardır. Anahtar Kelimeler: diyabetik retinopati, oksidatif stres, TAS, TOS, OSİ
Purpose: DRP is the most common microvascular complication of diabetes. Many mechanisms have been described in the pathogenesis of retinopathy. Oxidative stress plays an important role in the development of DRP. In this study, we aimed to investigate the role of TAS, TOS and OSI levels, as markers of oxidative stress, in the pathogenesis of diabetic retinopathy and their role in the early diagnosis and treatment of retinopathy. Materials and Methods: Thirty patients with diabetic retinopathy between the ages of 18-75, 34 patients with diabetes but no retinopathy, and 32 healthy control groups without a known chronic disease were included, who applied to the Internal Medicine and Ophthalmology outpatient clinic of Düzce University Faculty of Medicine between May 2021 and December 2021. Demographic data of the patients were recorded during the examination. All patients and healthy controls were screened for retinopathy using Optical Coherence Tomography (OCT) in the Ophthalmology Outpatient Clinic. For hemogram and biochemical parameters, the results of the patients who were recorded in written or electronic records in their routine outpatient clinic controls were used. TAS and TOS measurements were analyzed by colorimetric method after calibration-control procedures on RelAssay Diagnostics brand commercial kits in MINDRAY-BS400 brand device. Results are given in TAS mmol/L, TOS µmol/L. TOS/TAS ratio and OSI value were calculated. All obtained data were evaluated using SPSS 26.0 statistical package program. Results: A total of 96 patients were included in the study. Gender distribution, marital status, BMI, waist and hip circumferences were similar between the groups. DM duration, HbA1C, FPS, Proteinuria and TG levels were found to be higher in the group with DRP. While TOS measurements were found to be the lowest in the control group with a mean of 8.11 ± 2.87 µmol/L in the group with DRP, µmol/L 5.72 ±1.44 in the group without DRP, and 4.69 ± 1.40 µmol/L in the control group, it was statistically significant in the patient group with DRP. found high. TAS was found to be significantly higher with 1.26 ± 0.20 mmol/L in the control group and low in the diabetic patient group. 1.09 ± 0.171 mmol/L in the group with retinopathy, 1.16 ± in the group with DM without retinopathy. It was found to be low as 0.18 mmol/L, but it was not found to be statistically significant. The OSI value was found to be 0.76 ± 0.29 in the group with DRP and was found to be high, consistent with the TOS value. A positive correlation was observed between TOS and OSI levels and FPS, HbA1C, TSH, and TG. In the multivariate logistic regression analysis performed to predict DRP, total insulin dose, use of bolus insulin and diuretics, and high TOS and OSI levels were determined as an independent risk for diabetic retinopathy. Conclusion: In our study, by comparing diabetic cases and healthy control groups; It has been shown that low TAS levels are closely related to diabetes itself, but it is insufficient to show retinopathy. TOS and OSI measurements have high sensitivity and specificity in predicting the development of diabetic retinopathy. Disruption of the balance between oxidant and antioxidant, oxidative stress has been shown to play an important role in the etiopathogenesis of diabetic retinopathy. Calorimetric measurements of TOS and OSI levels may contribute to the early diagnosis, treatment and follow-up of diabetic retinopathy. However, further prospective studies are needed in this area. Keywords: diabetic retinopathy, oxidative stress, TAS, TOS, OSİ
Purpose: DRP is the most common microvascular complication of diabetes. Many mechanisms have been described in the pathogenesis of retinopathy. Oxidative stress plays an important role in the development of DRP. In this study, we aimed to investigate the role of TAS, TOS and OSI levels, as markers of oxidative stress, in the pathogenesis of diabetic retinopathy and their role in the early diagnosis and treatment of retinopathy. Materials and Methods: Thirty patients with diabetic retinopathy between the ages of 18-75, 34 patients with diabetes but no retinopathy, and 32 healthy control groups without a known chronic disease were included, who applied to the Internal Medicine and Ophthalmology outpatient clinic of Düzce University Faculty of Medicine between May 2021 and December 2021. Demographic data of the patients were recorded during the examination. All patients and healthy controls were screened for retinopathy using Optical Coherence Tomography (OCT) in the Ophthalmology Outpatient Clinic. For hemogram and biochemical parameters, the results of the patients who were recorded in written or electronic records in their routine outpatient clinic controls were used. TAS and TOS measurements were analyzed by colorimetric method after calibration-control procedures on RelAssay Diagnostics brand commercial kits in MINDRAY-BS400 brand device. Results are given in TAS mmol/L, TOS µmol/L. TOS/TAS ratio and OSI value were calculated. All obtained data were evaluated using SPSS 26.0 statistical package program. Results: A total of 96 patients were included in the study. Gender distribution, marital status, BMI, waist and hip circumferences were similar between the groups. DM duration, HbA1C, FPS, Proteinuria and TG levels were found to be higher in the group with DRP. While TOS measurements were found to be the lowest in the control group with a mean of 8.11 ± 2.87 µmol/L in the group with DRP, µmol/L 5.72 ±1.44 in the group without DRP, and 4.69 ± 1.40 µmol/L in the control group, it was statistically significant in the patient group with DRP. found high. TAS was found to be significantly higher with 1.26 ± 0.20 mmol/L in the control group and low in the diabetic patient group. 1.09 ± 0.171 mmol/L in the group with retinopathy, 1.16 ± in the group with DM without retinopathy. It was found to be low as 0.18 mmol/L, but it was not found to be statistically significant. The OSI value was found to be 0.76 ± 0.29 in the group with DRP and was found to be high, consistent with the TOS value. A positive correlation was observed between TOS and OSI levels and FPS, HbA1C, TSH, and TG. In the multivariate logistic regression analysis performed to predict DRP, total insulin dose, use of bolus insulin and diuretics, and high TOS and OSI levels were determined as an independent risk for diabetic retinopathy. Conclusion: In our study, by comparing diabetic cases and healthy control groups; It has been shown that low TAS levels are closely related to diabetes itself, but it is insufficient to show retinopathy. TOS and OSI measurements have high sensitivity and specificity in predicting the development of diabetic retinopathy. Disruption of the balance between oxidant and antioxidant, oxidative stress has been shown to play an important role in the etiopathogenesis of diabetic retinopathy. Calorimetric measurements of TOS and OSI levels may contribute to the early diagnosis, treatment and follow-up of diabetic retinopathy. However, further prospective studies are needed in this area. Keywords: diabetic retinopathy, oxidative stress, TAS, TOS, OSİ
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Keywords
diyabetik retinopati, oksidatif stres, TAS, TOS, OSİ, diabetic retinopathy, oxidative stress, TAS, TOS, OSİ, İç Hastalıkları, Internal diseases
