Serum total safra asidi ve GLP-1 seviyesinin glukoz toleransı ile olan ilişkisi
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Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Kırıkkale Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Araştırmamızda Gestasyonel Diyabetes Mellitus (GDM) tanılı gebelerde Glukagon Benzeri Peptid-1 (GLP-1) ve Total Safra Asidi (TSA) konsantrasyonlarının Glukoz Toleransı ile olan ilişkisini ortaya koymak amaçlanmaktadır. Gereç – Yöntem: Araştırmamız vaka kontrol çalışması olarak Kırıkkale Üniversitesi Tıp Fakültesi Hastanesi Kadın Hastalıkları ve Doğum Polikliniğine başvuran 18-45 yaş aralığındaki ve 24-28. haftalarda Oral Glukoz Tolerans Testi (OGTT) yapılan gebe kadınların dahil edilmesi şeklinde tasarlandı. Çalışma 20 (yirmi) GDM tanısı alan ve 20 (yirmi) sağlıklı gebe olmak üzere toplam 40 (kırk) vakadan oluşturuldu. Serum glukoz ölçümleri enzimatik hekzokinaz metotla, total safra asidi ölçümleri ise kolorimetrik metotla kit aplikasyonu sonrası otoanalizörde gerçekleştirildi. GLP-1 düzeyleri Human GLP-1 ELISA kiti ile manuel olarak analiz edildi. Bulgular: Araştırmaya katılan gebelerden kontrol grubunda olanların yaş ortalaması (27,95 ± 3,82) GDM grubunda olanların yaş ortalamasından (30,25 ± 4,91) istatistiksel olarak farklı değildi. VKİ açısından ise kontrol grubunun ortalamasının (27,01 ± 2,92 kg/m2) GDM grubunun ortalamasından (29,58 ± 4,31 kg/m2) istatistiksel olarak farklı olduğu saptanmıştır. Korelasyon analizi sonrası çok güçlü ve anlamlı korelasyon sadece kontrol grubu GLP-1 açlık ve GLP-1 1. saat (r=0,76 p=0,00) arasında mevcuttu. Güçlü ve anlamlı korelasyon ise kontrol grubunda TSA açlık ile TSA 1.saat (r=0,55 p=0,01) arasında ve GDM gurubunda TSA açlık ile TSA 1.saat (r=0,65 p=0,00) arasında mevcuttu. Grup içi karşılaştırmalarda hem kontrol grubunda hem de GDM grubunda GLP-1 açlık-GLP-1 1. saat ve TSA açlık-TSA 1. saat arasında istatistiksel olarak anlamlı fark bulunmadı. Gruplar arası karşılaştırmada VKİ (p=0,043), GLP-1 açlık (p=0,014) ve GLP-1 1. saat (p=0,004) arasında istatistiksel olarak anlamlı fark tespit edilirken yaş, TSA açlık ve TSA 1. saat arasında anlamlı fark tespit edilmedi. Sonuç: Çalışmamızda GLP-1 konsantrasyonlarının GDM'li grupta kontrol gruba göre daha yüksek ve anlamlı farklı olduğu tespit edilirken TSA konsantrasyonlarının karşılaştırmasında gruplar arasında anlamlı fark tespit edilmemiştir. GDM'li hastalarda oluşan insülin direncine tepki olarak GLP-1 konsantrasyonlarında artışın, azalan insülinotropik etkinin telafi edilmesi yönünde olduğunu göstermektedir. Gruplar arası TSA konsantrasyonlarının anlamlı farklı olmamasına rağmen referans aralığının üst kısmında bulunması glukoz toleransı açısından olası etkinin TSA alt gruplarından kaynaklandığını düşündürmektedir. Ayrıca TSA ile GLP-1 arasında korelasyonun bulunmaması da birbirlerinden bağımsız olarak veya TSA alt gruplar ile ilişkili olarak etkili olabileceklerini göstermektedir.
Aim: Our research aims to reveal the relationship between Glukagon Like Peptid-1 (GLP-1) and Total Bile Acid (TBA) concentrations and Glucose Tolerance in pregnant women diagnosed with Gestational Diabetes Mellitus (GDM). Material and Method: Our research was designed as a case-control study to include pregnant women between the ages of 18-45 who applied to Kırıkkale University Faculty of Medicine Hospital Gynecology and Obstetrics Polyclinic and underwent Oral glucose tolerance test (OGTT) at 24-28 weeks. The study consisted of a total of 40 (forty) cases, 20 (twenty) diagnosed with GDM and 20 (twenty) healthy pregnant women. Serum glucose measurements were performed by the enzymatic hexokinase method, and total bile acid measurements were performed by the colorimetric method in the autoanalyzer after kit application. GLP-1 levels were analyzed manually with the Human GLP-1 ELISA kit. Results: Among the pregnant women participating in the study, the average age of the control group (27.95 ± 3.82) was not statistically different from the average age of the GDM group (30.25 ± 4.91). In terms of Body Mass Index (BMI), it was determined that the average of the control group (27.01 ± 2.92 kg/m2) was statistically different from the average of the GDM group (29.58 ± 4.31 kg/m2). After correlation analysis, a very strong and significant correlation was found only between GLP-1 fasting and GLP-1 1st hour (r=0.76 p=0.00) in the control group. A strong and significant correlation existed between TBA fasting and TBA 1st hour in the control group (r=0.55 p=0.01) and between TBA fasting and TBA 1st hour in the GDM group (r=0,65 p=0,00). In intra-group comparisons, no statistically significant difference was found between GLP-1 fasting-GLP-1 1st hour and TBA fasting-TBA 1st hour in both the control group and the GDM group. In the comparison between groups, a statistically significant difference was detected between BMI (p=0,043), GLP-1 fasting (p=0,014) and GLP-1 1st hour (p=0,004), while no significant difference was detected between age, TBA fasting and TBA 1st hour. Conclusion: In our study, GLP-1 concentrations were found to be higher and significantly different in the GDM group than in the control group, while no significant difference was detected between the groups in the comparison of TBA concentrations. It shows that the increase in GLP-1 concentrations in response to insulin resistance in patients with GDM is to compensate for the decreased insulinotropic effect. Although TBA concentrations were not significantly different between groups, the fact that they were found at the upper end of the reference range suggests that the possible effect in terms of glucose tolerance is due to TBA subgroups. Additionally, the lack of correlation between TBA and GLP-1 indicates that they may be effective independently of each other or in association with TBA subgroups.
Aim: Our research aims to reveal the relationship between Glukagon Like Peptid-1 (GLP-1) and Total Bile Acid (TBA) concentrations and Glucose Tolerance in pregnant women diagnosed with Gestational Diabetes Mellitus (GDM). Material and Method: Our research was designed as a case-control study to include pregnant women between the ages of 18-45 who applied to Kırıkkale University Faculty of Medicine Hospital Gynecology and Obstetrics Polyclinic and underwent Oral glucose tolerance test (OGTT) at 24-28 weeks. The study consisted of a total of 40 (forty) cases, 20 (twenty) diagnosed with GDM and 20 (twenty) healthy pregnant women. Serum glucose measurements were performed by the enzymatic hexokinase method, and total bile acid measurements were performed by the colorimetric method in the autoanalyzer after kit application. GLP-1 levels were analyzed manually with the Human GLP-1 ELISA kit. Results: Among the pregnant women participating in the study, the average age of the control group (27.95 ± 3.82) was not statistically different from the average age of the GDM group (30.25 ± 4.91). In terms of Body Mass Index (BMI), it was determined that the average of the control group (27.01 ± 2.92 kg/m2) was statistically different from the average of the GDM group (29.58 ± 4.31 kg/m2). After correlation analysis, a very strong and significant correlation was found only between GLP-1 fasting and GLP-1 1st hour (r=0.76 p=0.00) in the control group. A strong and significant correlation existed between TBA fasting and TBA 1st hour in the control group (r=0.55 p=0.01) and between TBA fasting and TBA 1st hour in the GDM group (r=0,65 p=0,00). In intra-group comparisons, no statistically significant difference was found between GLP-1 fasting-GLP-1 1st hour and TBA fasting-TBA 1st hour in both the control group and the GDM group. In the comparison between groups, a statistically significant difference was detected between BMI (p=0,043), GLP-1 fasting (p=0,014) and GLP-1 1st hour (p=0,004), while no significant difference was detected between age, TBA fasting and TBA 1st hour. Conclusion: In our study, GLP-1 concentrations were found to be higher and significantly different in the GDM group than in the control group, while no significant difference was detected between the groups in the comparison of TBA concentrations. It shows that the increase in GLP-1 concentrations in response to insulin resistance in patients with GDM is to compensate for the decreased insulinotropic effect. Although TBA concentrations were not significantly different between groups, the fact that they were found at the upper end of the reference range suggests that the possible effect in terms of glucose tolerance is due to TBA subgroups. Additionally, the lack of correlation between TBA and GLP-1 indicates that they may be effective independently of each other or in association with TBA subgroups.
Açıklama
Tıp Fakültesi, Tıbbi Biyokimya Ana Bilim Dalı
Anahtar Kelimeler
Biyokimya, Biochemistry
