Agustos 2011
Inflamatuvar barsak hastaliginda mikroalbuminüri
Microalbuminuria in inflammatory bowel diease
- Ana Sayfa
- Sayılar
- Agustos 2011
- Inflamatuvar barsak hastaliginda mikroalbuminüri...
Bakirköy Dr. Sadi Konuk Egitim ve Arastirma Hastanesi, 2Gastroenteroloji Klinigi, Istanbul
Türkiye Yüksek Ihtisas Hastanesi, 3Immunoloji Laboratuvari, 4Biyokimya Laboratuvari ve 5Gastroenteroloji Klinigi, Ankara
Özet
Mikroalbüminürinin, inflamatuvar barsak hastaliginin tipini ve aktivitesini yansitan iyi bir parametre olup olmadigini ve TH1/TH2 sitokinleri olan IFN-γ/IL-4 serum düzeyleriyle bir korelasyon gösterip göstermedigini arastirmayi amaçladik. Gereç ve Yöntem: Çalismaya, 31 ülseratif kolit, 18 Crohn hastasi ve 8 saglikli kontrol alindi. Serum örneklerinde kreatinin, β-2 mikroglobulin, IL-4 ve IFN-γ, 24 saatlik idrarda kreatinin, mikroalbümin ve β-2 mikroglobulin çalisildi. Bulgular: Böbrek islevleri açisindan, ülseratif kolit grubunun kreatinin klerensi daha düsük gibi görünse de, ülseratif kolit, Crohn hastaligi ve saglikli kontrol gruplari arasinda istatistiksel önemde farklilik yoktu. Her üç grubun da idrar β-2 mikroglobulin seviyesi ölçülebilecek düzeyin altindaydi, yani tübüler hasar yoktu. Serum IL-4 düzeyi, ülseratif kolit grubunda kontrol grubundan istatistiksel önemde yükseklik gösteriyordu (49.3±81.7 pg/ml, 1.6±0.0 pg/ml, p<0.01). Ülseratif kolit grubunun mikroalbüminüri miktari kontrolden fazlaydi, ama farklilik istatistiksel önemde degildi. Crohn hastaligi grubunun IL-4 düzeyi (54.8±58 pg/ml) hem ülseratif kolit hem de kontrolden yüksekti, ancak sadece kontrol grubuyla anlamli farklilik gösteriyordu (p<0.01). Bütün çalisma gruplarinin serum IFN-γ düzeyleri, ölçülebilir düzeyin altindaydi. Serum β-2 mikroglobulin düzeyleri, gruplar arasinda farklilik göstermiyordu. Sonuç: Mikroalbüminüri, serum IFN-γ ile serum β-2 mikroglobulin düzeyleri inflamatuvar barsak hastaliginin tanisinda veya aktivasyonunu belirlemede yetersizdir. IL-4 düzeyi, inflamatuvar barsak hastaligi grubunda aktivasyonla iliskisiz olarak yüksektir, ancak kontrol grubuyla benzer degerleri gösteren hasta sayisi çok oldugundan, rutin kullanima girmesi uzak bir olasiliktir.
Abstract
We aimed to investigate whether microalbuminuria reflects inflammatory bowel disease type and/or activity and whether there is any relation between microalbuminuria and serum levels of TH1/TH2 cytokines IFN-γ/interleukin (IL)-4. Materials and Methods: Thirty-one ulcerative colitis and 18 Crohn’s disease patients together with 8 healthy controls were enrolled into the study. Serum creatinine, β-2 microglobulin, IL-4, and IFN-γ levels together with 24hour urine creatinine, microalbumin and β-2 microglobulin levels were studied. Results: Although the creatinine clearance level of the ulcerative colitis group seemed lower than of the healthy control group, no statistically important difference in renal function was present between the ulcerative colitis, Crohn’s disease and healthy control groups. Urine β-2 microglobulin levels of all three study groups were found lower than the detectable level, so tubular damage was not present. Serum IL-4 level of the ulcerative colitis group was found significantly higher than of the healthy control group (49.3±81.7 pg/ml, 1.6±0.0 pg/ml, respectively; p<0.01). The microalbuminuria level of the ulcerative colitis group was found minimally higher than of the healthy control group, but the difference was insignificant. The serum IL4 level of the Crohn’s disease group (54.8±58 pg/ml) was found higher than both the ulcerative colitis and healthy control groups, but a statistically significant difference was present only with the healthy control group (p<0.01). Serum IFN-γ levels of all study groups were found lower than the detectable level. No difference was detected in the β-2 microglobulin level between the study groups. Conclusions: Microalbuminuria and serum IFN-γ and β-2 microglobulin levels were insufficient in the diagnosis of inflammatory bowel disease and in determining the activation of the disease. Serum IL-4 levels were high in inflammatory bowel disease without any relation with activation. However, the number of patients with values similar to those of the healthy control group was high, so its routine usage seems to be unjustified.
