Korelacija između kvantifikacionih skorova metaboličkog sindroma i brojnih laboratorijskih parametara udruženih sa njim
Sažetak
Uvod/Cilj. Metabolički sindrom (MS) karakterišu osnovni faktori rizika [obim struka (OS), poremećaji glikoregulacije, hipertenzija, hipertrigliceridemija, nizak HDL-holesterol] kao i pridruženi faktori rizika – insulinska rezistencija (IR), C-reaktivni protein (CRP), mokraćna kiselina, inhibitor aktivacije plazminogena-1 (PAI-1), fibrinogen, hiperhomocisteinemija (HHci), nealkoholna masna bolest jetre (NAMBJ) i mikroalbuminurija. Cilj rada bio je da se analiziraju osnovni i pridruženi faktori rizika od MS kod bolesnika sa i bez MS i ustanovi korelacija siMS skora i siMS skora rizika sa osnovnim i pridruženim faktorima rizika od MS. Metode. Studijom su bila obuhvaćena 148 bolesnika sa prekomernom telesnom težinom [body mass index ((BMI) 25–30 kg/m2) i gojazni (BMI > 30 kg/m2), starosti 30–75 godina, podeljeni u dve grupe: I – sa MS (68 bolesnika) i II – bez MS (80 bolesnika). Korišćeni su siMS skor, kao metod za kvantifikaciju MS, i siMS skor rizika, kao indikator aterosklerotskih komplikacija. Rezultati. Bolesnici sa MS imali su statistički značajno više vrednosti OS, hipertenzije, triglicerida (p < 0,001), glikemije (p = 0,006), kao i pridruženih faktora rizika od MS [HOMA IR (p = 0,002) CRP (p = 0,01) mokraćne kiseline (p < 0,001), alanin aminotranferaze (ALT) (p = 0,007) i gama-glutamil transferaze (GGT) (p = 0,001)] i niže vrednosti HDL-holesterol, (p < 0,001) u odnosu na bolesnika bez MS. Skor siMS pokazao je korelaciju sa pridruženim faktorima MS [log HOMA IR, logCRP, mokraćnom kiselinom (p < 0,001) i fibrinogenom (p = 0,005), parametrima jetrene funkcije: logALT (p = 0,001), log GGT, (p < 0,001) i bubrežne funkcije: kreatininom (p = 0,013) i serumskim proteinima (p = 0,006)]. Skor siMS rizika je statistički značajno korelirao sa vrednostima homocisteina, trombocita, mokraćne kiseline, uree, albumina i proteina. Zaključak. Statistički značajno više vrednosti pridruženih faktora rizika od MS (HOMA-R, CRP, mokraćne kiseline, ALT, GGT) kod bolesnika sa MS potvrđene su i korelacijom sa siMS skorom. Skor siMS ukazuje na to da su insulinska rezisencija, CRP, fibrinogen, mokraćna kiselina, NAMBJ pridruženi faktori rizika od MS. Skor siMS rizika ukazuje na to da gojaznost i hiperproteinski unos povećavaju HHCi sa starenjem, te da povećavaju rizik od bubrežnih poremećaja i aterosklerotskih komplikacija.
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