Aralik 2014
Normal alanin aminotransferaz düzeyli nonalkolik yagli karaciger hastaliginda insülin direnci ve metabolik sendrom
Insulin resistance and metabolic syndrome in non-alcoholic fatty liver disease with normal alanine aminotransferase levels
- Ana Sayfa
- Sayılar
- Aralik 2014
- Normal alanin aminotransferaz düzeyli nonalkolik yagli karaciger hastaliginda insülin direnci ve metabolik sendrom...
Özet
Giris ve Amaç:Çalismamizin amaci; toplum prevalansi yüksek olan normal alanin aminotransferaz düzeyli nonalkolik yagli karaciger hastaligindaki insülin direncini ve metabolik sendrom kriterini arastirmaktir. Gereç ve Yöntem:Çalismaya ultrasonografi ile hepatosteatozu saptanan ve alanin aminotransferaz düzeyleri normal olan gelisigüzel seçilen 50 kisilik çalisma grubu ile yine normal alanin aminotransferaz düzeyli ultrasonografi ile hepatosteatozu saptanmayan yine gelisigüzel seçilen 50 kisilik kontrol grubu alindi. Hepatosteatozu olanlar evre I, II ve III olarak kendi arasinda gruplandi. Her bir grup Dünya Saglik Örgütü ve Ulusal Kolestrol Egitim Programi-Eriskin Tedavi Paneli III’e göre metabolik sendrom tani kriterleri açisindan degerlendirildi. Bulgular: Gruplar arasindaki karsilastirmada insülin rezistansinin degerlendirilmesinde homeostatik model degeri normal alanin aminotransferaz düzeyli nonalkolik yagli karaciger hastaligi grubunda, kontrol grubuna göre anlamli olarak yüksek saptandi (p=0.042). Yine normal aralikta olmakla birlikte alanin aminotransferaz degeri de steatozlularda anlamli olarak yüksek idi (p=0.016). Dünya Saglik Örgütü’ne göre hesaplanan metabolik sendrom sikligi steatozu olmayanlarda %36 iken, normal alanin aminotransferaz düzeyli nonalkolik yagli karaciger hastaligi olanlarda %64 ile anlamli olarak yüksek idi (p=0.005). Hepatosteatozu olan grup ultrasonografide saptanan hepatosteatoz derecelerine göre grupladirildiginda; gruplar arasinda evre arttikça aspartat aminotransferaz ve alanin aminotransferaz degerlerinin de anlamli olarak arttigi görülmektedir (p<0.001 ve p=0.004). Sonuç:Nonalkolik yagli karaciger hastaligi olan bireyler alanin aminotransferaz düzeylerinden bagimsiz olarak, insülin direnci ve metabolik sendrom açisindan taranmalidir
Abstract
Background and Aims: The aim of the study is to investigate insulin resistance and metabolic syndrome criterion in non-alcoholic fatty liver disease patients who have normal alanine aminotransferase levels, which is prevalent in the community. Materials and Methods:The study looked at 100 subjects, randomized into two groups of 50. The study group consisted of subjects with normal alanine aminotransferase levels and hepatosteatosis detected by ultrasonography; the control group, again randomized, were subjects with normal alanine aminotransferase levels but no hepatosteatosis as detected by ultrasonography. Subjects with hepatosteatosis were grouped by grade I, II, or III. Each group was evaluated with respect to metabolic syndrome diagnosis criteria in accordance with The World Health Organization and the National Cholesterol Education Programme-Adult Treatment Panel III. Results:The homeostatic model assessment of insulin resistance values were found to be significantly higher in the group with non-alcoholic fatty liver disease and normal alanine aminotransferase levels (p=0.042); and although alanine aminotransferase level were within the normal range, they were significantly higher in the study group compared to control group (P=0.016). Estimated metabolic syndrome frequency according to The World Health Organization was 36% and 64% in control and study groups respectively, which was statistically significant (p=0.005). The study group’s aspartate aminotransferase and alanine aminotransferase levels significantly increased (p<0.001, p=0.004) as hepatosteatose grades, detected by ultrasonography, increased. Conclusion: Individuals with non-alcoholic fatty liver disease should be screened for insulin resistance and metabolic syndrome, independent of alanine aminotransferase levels.
