Metabolički sindrom kod pacijenata sa lupus nefritisom
Metabolički sindrom i lupus nefritis
Sažetak
Sažetak:
Uvod/cilj: Metabolički sindrom (MetS) kod bolesnika sa SLE, predstavlja dodatno opterećenjei loš prognostički faktor za nastanak ili pogoršanje ateroskleroze i za kardiovaskularne komplikacije.
Kod mnogih bolesnika sa lupus nefritisom (LN) MetS je često inicijalno već ispoljen.
Cilj našeg rada bio je da utvrdimo učestalost i karakteristike MetS kod bolesnika sa LN, kao i
odnos komponenti Met Si aktivnosti lupus nefritisa.
Materijal i metode: Kliničko ispitivanje je obuhvatilo grupu od 67 pacijenata sa LN, 54 (80,59%) ženskog pola i 13 (19,41%) muškaraca, prosečnih godina starosti 42,86±14,46. Pacijenti su podeljeni u dve grupe : prva sa MetS (35,82%) i druga bez MetS (64,18%), pacijenti su imali aktivan LN (34-50,74%) i LN u remisiji (33-49,25%). Pratili smo kliničke i biohemijske parametre od interesa.
Rezultati: Poredeći pacijente sa LN zbirno kao i one sa MetS i bez MetS, utvrdili smo da su pacijenti sa MetS bili stariji (p = 0.001), BMI (p<0.001) i sistolni pritisak je bio viši (p=0.002) i pušači su bili zastupljeniji u ovoj grupi (p<0.001). U analizama povišeni trigliceridi (p<0.001) i kreatinin (p=0.027) i snižen albumin (p=0.050) i GFR (p= 0.020) su zapaženi u grupi sa MetS. MetS je bio zastupljen kod 44,11% pacijenata sa aktivnim LN i kod 27.7% sa LN u remisiji. Najzastupljeniji parameter MetS bila arterijska hipertenzija (76.6%) koja značajno korelirala sa GFR i kreatininom; hipertrigliceridemija (47.8%) koja je korelirala sa anti ds DNA At, eritrociturijom, proteinurijom i SLEDAI/r indeksom ; snižen HDL holesterol (28.4%) koji je korelirao značajno sa albuminom, C3 i anti ds DNA At.
Zaključak: Kod naših pacijenata sa LN, MetS je bio povezan sa starijim životnim dobom, poremćjem bubrežne funkcije i pušenjem. Najzastupljeniji parameter MetS kod pacijenata sa LN bila je arterijska hipertenzija i dislipidemija koja je značajno korelirala sa parametrima aktivnosti bolesti, što upućuje na povećan rizik od kardiovaskularnin komplikacija u ovoj grupi bolesnika.
Reference
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Sva prava zadržana (c) 2024 Dr sc. med. Violeta Rabrenović, Milica Petrovic, Milorad Rabrenovic, Nemanja Rancic
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