Tip 1 diabetes mellituslu çocukların retinal doppler ultrasonografi bulguları ve homosistein düzeyleri
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Date
2008
Authors
Şen, Tolga Altuğ
Bükülmez, Ayşegül
Köken, Reşit
Demir, Tevfik
Albayrak, Ramazan
Değirmenci, Bumin
Acar, Murat
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Amaç: Tip 1 diyabetli çocuklarda diyabetik retinopatiyle ilişkili oldukları düşünülen plazma homosistein düzeylerinin ölçülmeleri, retinal arterlerdeki kan akım hızlarının Doppler ultrasonografiyle değerlendirilerek sağlıklı çocukların ölçümleriyle kıyaslanmaları için bu çalışma planlanmıştır. Gereç ve Yöntem: Çalışmamız için tip 1 diyabet tanısıyla izlenen yaşları 8-18 (Ortalama 13,2±4,3) arasında olan, 42 hasta (22 kız, 20 erkek) seçilmiştir. Tip 1 diyabet tanılı çocukların ortalama hastalık süreleri 5,02±2,99 yıldır. Kontrol grubu için yaşları 9-18 (Ortalama 14,01±3,5) arasında olan 30 çocuk (15 erkek, 15 kız) seçilmiştir. Vakaların santral retinal arter ve oftalmik arterlerinden pik sistolik hız, diyastolik hız, rezistivite indeksi ve pulsatilite indeksi ölçümleri yapılmıştır. Bulgular: Tip 1 diyabetli çocuklarla kontrol grubundaki çocuklar arasında sadece santral retinal arter diyastolik hızları için, iyi ve kötü kontrollü tip 1 diyabetli çocukların arasında ise sadece oftalmik arter Vmax ölçümleri için anlamlı farklılıklar bulunurken (p<0,05), diğer ölçüm değerleri için aradaki farklar anlamlı bulunmamıştır (p>0,05). Kötü metabolik kontrollü tip 1 diyabetli hastaların oftalmik arter rezistivite indeksleri (0,82±0,04), iyi metabolik kontrollü tip 1 diyabetli hastaların rezistivite indekslerine göre (0,76±0,08) daha yüksek bulunmuştur. Tip 1 diyabet tanılı çocukların ortalama homosistein düzeylerinin (10,3±2,18 μmol/L), kontrol grubundaki çocuklara (9,12±1,9 μmol/L) göre daha yüksek, kötü kontrollü tip 1 diyabetli çocukların ortalama homosistein düzeylerinin (11,33±2 ,05 μmol/L) iyi kontrollü çocuklara (9,42±2,12 μmol/L) göre daha yüksek olduğu ve aradaki farkların anlamlı olduğu tespit edilmiştir (p<0,05). Sonuç: Kötü kontrollü tip 1 diyabetes mellituslu çocuklarda plazma homosistein düzeyleri ve oftalmik arter rezistivite indeksleri, iyi kontrollü tip 1 diyabetli çocuklara ve sağlıklı çocuklara kıyasla artmıştır. Bu artışlar ilerideki dönemde diyabetik retinopati gelişmesi açısından risk oluşturabilir.
Aim: We aimed to measure plasma homocysteine levels and retinal arterial blood flow of type 1 diabetic children by Doppler ultrasound, which were known to be related with diabetic retinopathy and to compare them with healthy children. Materials and Methods: We selected 42 diabetic children (22 females, 20 males), between the ages of 8 to18 years (mean 13,2±4,3). Mean duration of type 1 diabetes was 5,02±2,99 years. For the control group, 30 children (15 females, 15 males) between the ages of 9 to 18 years (mean 14,01±3,5) were selected. In central retinal arteries and ophthalmic arteries, peak systolic velocity, diastolic velocity, pulsatility and resistivity indexes were measured. Results: Except for the higher central retinal artery diastolic velocity in the control group, retinal blood flow velocities were similiar in diabetic children and the control group (p<0,05). There was no significant correlation between the duration of diabetes and the retinal blood flow velocities of diabetic children (p>0,05). Mean ophthalmic artery peak systolic velocity (37,33±12,79 cm/sec) for well controlled diabetic children was higher than the poorly controlled group (31,1±17,17 cm/sec); mean ophthalmic artery resistivity index (0,76±0,08) for well controlled group was lower than the mean resistivity index (0,82±0,04) of poorly controlled group. Plasma homocysteine levels were higher in diabetic children (10,3±2,18 μmol/L) than the control group (9,12±1,9 μmol/L) (p<0,05). Plasma homocysteine levels of the poorly controlled diabetics (9,42±2,12 μmol/L) were higher than the well controlled diabetics (11,33±2,05 μmol/L). Conclusion: In the poorly controlled group total plasma homocysteine levels and ophthalmic artery resistivity indexes were increased compared to the well controlled diabetics and healthy children which might be risk factors for diabetic retinopathy.
Aim: We aimed to measure plasma homocysteine levels and retinal arterial blood flow of type 1 diabetic children by Doppler ultrasound, which were known to be related with diabetic retinopathy and to compare them with healthy children. Materials and Methods: We selected 42 diabetic children (22 females, 20 males), between the ages of 8 to18 years (mean 13,2±4,3). Mean duration of type 1 diabetes was 5,02±2,99 years. For the control group, 30 children (15 females, 15 males) between the ages of 9 to 18 years (mean 14,01±3,5) were selected. In central retinal arteries and ophthalmic arteries, peak systolic velocity, diastolic velocity, pulsatility and resistivity indexes were measured. Results: Except for the higher central retinal artery diastolic velocity in the control group, retinal blood flow velocities were similiar in diabetic children and the control group (p<0,05). There was no significant correlation between the duration of diabetes and the retinal blood flow velocities of diabetic children (p>0,05). Mean ophthalmic artery peak systolic velocity (37,33±12,79 cm/sec) for well controlled diabetic children was higher than the poorly controlled group (31,1±17,17 cm/sec); mean ophthalmic artery resistivity index (0,76±0,08) for well controlled group was lower than the mean resistivity index (0,82±0,04) of poorly controlled group. Plasma homocysteine levels were higher in diabetic children (10,3±2,18 μmol/L) than the control group (9,12±1,9 μmol/L) (p<0,05). Plasma homocysteine levels of the poorly controlled diabetics (9,42±2,12 μmol/L) were higher than the well controlled diabetics (11,33±2,05 μmol/L). Conclusion: In the poorly controlled group total plasma homocysteine levels and ophthalmic artery resistivity indexes were increased compared to the well controlled diabetics and healthy children which might be risk factors for diabetic retinopathy.
Description
Keywords
Doppler ultrasonografi, Tip 1 diyabet, Çocuklar, Retinal kan akımı, Retina, Homosistein, Doppler ultrasound, Type 1 diabetes, Children, Retinal blood flow, Homocysteine
Citation
Şen, T. A. vd. (2008). "Tip 1 diabetes mellituslu çocukların retinal doppler ultrasonografi bulguları ve homosistein düzeyleri". Güncel Pediatri, 6(1), 19-25.