Kriterijumska validnost metaboličkih i antropometrijskih prediktora u sindromu dijabetesnog stopala
Sažetak
Uvod/Cilj. Sindrom dijabetesnog stopala (SDS) javlja se kod skoro 15% pacijenata sa dijabetes melitusom (DM) i najčešći je uzrok njihove hospitalizacije, prolongiranog bolničkog lečenja i amputacija donjih ekstremiteta. U studiji je procenjena diskriminaciona validnost pokazatelja glikoregulacije, lipoproteinskog statusa i indeksa telesne mase (ITM) u detekciji SDS kod pacijenata sa DM. Metode. U uporednoj, opservacionoj studiji, ispitivanu grupu sačinjavali su pacijenti sa DM i SDS, a kontrolnu zdravi dobrovoljci. Metabolički prediktori izmereni u studiji bili su: glikemija našte (GN), post-prandijalna glikemija (PPG), glikozilirani hemoglobin (HbA1c), ukupni holesterol, ukupni trigliceridi, lipoproteini male gustine (LDLc) i lipoproteni visoke gustine (HDLc). ITM je izmeren kao antropometrijska varijabla. Kriterijumska validnost metaboličkih i antropometrijskih varijabli procenjena je procedurom prijemno operativnih karakteristika. Rezultati. Ukupno je opservirano 70 pacijenata sa DM i 60 zdravih dobrovoljaca. Procedurom prijemno operativnih karakteristika dokazano je pet značajnih prediktora SDS. Kriterijumske vrednosti za HbA1c, GN, PPG, LDLc i ITM, iznosile su, redom: 6.3%, 6.3 mmol/L, 7.1 mmol/L, 4.39 mmol/L i 25 kg/m2. Pronađene su značajno veće površine ispod krivih kod svih glikometaboličkih varijabli u odnosu na površinu ispod krive za LDLc, kao i u odnosu na površinu ispod krive za ITM. Zaključak. Prevencija SDS kod obolelih pacijenata sa DM, mora da uključi intenziviranje dijetetskih mera uz tretman povišenih vrednosti glikemije našte, postprandijalne glikemije i LDLc i to, pri njihovim nižim vrednostima u odnosu na aktuelne preporučene vrednosti za pacijente sa DM. Smanjenju telesne mase kod pacijenata sa DM, neophodno je pristupiti još u periodu njihove pre-gojaznosti.
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