Sağlıklı bireylerde IGF-1 düzeyleri ile endotel disfonksiyonu arasındaki ilişkinin araştırılması ve aterosklerozun bir göstergesi olarak IGF-1
Associaton between serum IGF-1 levels in healthy individuals and endothelial dysfunction,and IGF-1 as a marker of atherosclerosis
- Tez No: 192433
- Danışmanlar: PROF.DR. METİN ARSLAN
- Tez Türü: Tıpta Uzmanlık
- Konular: Biyokimya, Endokrinoloji ve Metabolizma Hastalıkları, Biochemistry, Endocrinology and Metabolic Diseases
- Anahtar Kelimeler: Belirtilmemiş.
- Yıl: 2006
- Dil: Türkçe
- Üniversite: Gazi Üniversitesi
- Enstitü: Tıp Fakültesi
- Ana Bilim Dalı: İç Hastalıkları Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: Belirtilmemiş.
Özet
6$ö/,./,%ø5(</(5'(ø16h/ø1-/ø.(*52:7+)$.7g5-I(IGF-,'h=(</(5øø/((1'27(/'ø6)21.6ø<218$5$6,1'$.øø/øù.ø1ø1$5$ù7,5,/0$6,9($7(526./(52=81%ø5*g67(5*(6ø2/$5$.,*)-I'5)1(6/ø+$1d8+$&,Ateroskleroz; KAH, PDH ve AMI'ne neden olabilen, kompleks ve kronik bir süreçtir.$WHURVNOHUR]XQ JHOLúLPLQGH HUNHQ G|QHPGH ROXúDQ YH PDM|U URO RODQ IDNW|U HQGRWHOGLVIRQNVL\RQXGXU 12 ÂUHWLPLQLQ EX G|QHPGH D]DOGÃֈ ,*F-,¶LQ 12 ÂUHWLPLQL VWLPXOH HWWL÷Lve bu nedenle de IGF-, YH HQGRWHO GLVIRQNVL\RQX GROD\ÃVÃ\OD GD DWHURVNOHUR] JHOLúLPLIGF-, LOH .$+ DUDVÃQGD LOLúNL ROGX÷X \DSÃODQDUDVÃQGD LOLúNL RODELOHFH÷L GÂúÂQÂOPHNWHGLUateroskleroz patogenezinde insülin direnci ve endoteloDOÃúPDODUOD J|VWHULOPLúWLU $\UÃFDGLVIRQNVL\RQXQXQPHUNH]LELUURODOGÃ÷ÃQDGDLUELOJLOHUJLGHUHNDUWPDNWDGÃUIGF-,GÂ]H\LGÂúÂN YH \ÂNVHN ¶úHU NLúL LOH QRUPDO RODQ NLúL dahildDOÃúPDPÃ]adüzeyini etkilHGL÷LHGLOPLúWLU dDOÃúPDPÃ]GD VHUXP ,*)-I ELOLQHQ '0 NURQLN NDUDFL÷HUEndotel disfonksiyonununKDVWDOÃ÷ÃYHNURQLNE|EUHNKDVWDOÃ÷ÃRODQODULQFHOHPHGÃúÃEÃUDNÃOGÃ.belirteçlerinden olan NO ve ET-I ile IGF-, DUDVÃQGD YH \LQH HQGRWHO GLVIRQNVL\RQXQDlipid düzeyleri veGROD\ÃVÃ\ODGDDWHURVNOHUR]DNDWNÃVÃROGX÷XELOLQHQULVNIDNW|UOHULQGHQ&53fibrinojen düzeyleri ile IGF-,DUDVÃQGDNLLOLúNLLQFHOHQdi. IGF-I düzeyleri ile NO, ET-I, hs-CRP, fibrinojen ve lipid düzeyleri DUDVÃQGD LOLúNLbulunamaGÃAncak IGF-I düzeyi yüksek olan grupta NO ile TG ve VLDL-.DUDVÃQGD pozitifbir korelasyon tespit edildi. $\UÃFD OLWHUDWÂU EXOJXODUÃQÃQ WHUVLQH ,*)-, GÂ]H\L GÂúÂN RODQpozitifJUXSWD12LOH LQVÂOLQGLUHQFLDUDVÃQGDLVWDWLVWLNVHORODUDNDQODPOÃIDUNOÃOÃ÷DQHGHQRODQbu grupta endotel disfonksiyonunun belirteçlerinden olan NO ileELU NRUHODV\RQ YDUGà YHLDL-K, VLDL-.7*YHWRWDONROHVWHURODUDVÃQGDda DQODPOÃELU LOLúNLEXOXQGXBu bulgular,erken dönemde NO'inEX NDUGL\RYDVNÂOHU ULVN IDNW|UOHULQLQ DUWÃúÃQD LNLQFLO RODUDN |]HOlikleIGF-I düzeyleri ile hs-CRP,ELU VDYXQPD PHNDQL]PDVà RODUDNDUWDELOHFH÷LQL GÂúÂQGÂUPÂúWÂUfibrinojen ve lipid düzeyleri DUDVÃQGD ELU LOLúNL EXOXQDPDGà DQFDN ,*)-,¶L GÂúÂN RODQ JUXSWDfibrinojen düzeyleri daha yüksek bulundu. Yine IGF-,¶L GÂúÂNGL÷HU JUXED J|UH KV-CRP,olan grupta ET-I ile hs-&53GÂ]H\LDUDVÃQGDSR]LWLIELULOLúNLVDSWDQGÃ. Bu bulgular ise IGF-IGÂúÂNOÂ÷ÂQÂQ EX EHOLUWHoOHU Â]HULQGHQ DWHURVNOHUR]D NDWNÃGD EXOXQDELOHFH÷LQLGÂúÂQGÂUPÂúWÂU dDOÃúPDPÃ]ÃQ RULMLQDO EXOJXVX LVH LQVÂOLQ GLUHQFL LOH 9.ø DUDVÃQGD DQODPOÃbir korelasyon tespit edilmesiydi.Sonuç olarak IGF-,GÂúÂNOÂ÷ÂQÂQHUNHQG|QHPDWHURVNOHUR]XQEHOLUOHQPHVLQHNDWNÃGDEXOXQDELOHFH÷L DQFDN EX NLúLOHULQ X]XQ G|QHPOL WDNLSOHULQLQ \DSÃODFDֈ oDOÃúPDODUOD JHUoHNULVNLQRUWD\DNRQDELOHFH÷LGÂúÂQÂOPÂúWÂU
Özet (Çeviri)
$662&ø$721%(7:((16(580ø168/ø1-/ø.(*52:7+FACTOR-I (IGF-I)/(9(/6ø1+($/7+<ø1'ø9ø'8$/6$1'(1'27+(/ø$/'<6)81&7ø21 AND IGF-I AS A MARKER OFATHEROSCLEROSø6'5)1(6/ø+$1d8+$&,Atherosclerosis, which may cause coronary artery disease, peripheral artery diseaseand acute myocardial infarction is a complex and chronic process. Endothelial dysfunction isan early and major factor in the development of atherosclerosis. It is considered that, in theHDUO\ VWDWH RI DWKHURVFOHURVLV QLWULF R[LGH 12 SURGXFWLRQ LV UHGXFHG DQG VLQFH øQVXOLQ-likegrowth factor-I (IGF-I) stimulates NO production there is relation between IGF-I andendothelial dysfunction and consequently relation between IGF-I and atherosclerosisdevelopment. It has been shown that there is a relation between IGF-I and coronary arterydisease. Also there is increasing evidence that, insulin resistance and endothelial dysfunctionplay a central role in the pathogenesis of atherosclerosis.Our study include 67 participant, who are divided into three groups according to theirIGF-I levels.There was 17 subject in IGF-I lower group, 17 in the higher and 33 in the normalgroup.Their age was between 40-65 years old, and body mass index < 27 kg/m2 . History ofdiabetes mellitus, chronic liver and kidney disease didn?t accept to the study, because thesediseases can affect IGF-I levels. Also people who have hypertension didn?t take place in thestudy though it is a cardiovascular risk factor. Relationship between IGF-I and NO,Endothelin-I (ET-I), markers of endothelial dysfunction, and also between IGF-I and C-reactive protein (CRP), lipid and fibrinogen levels, risk factors that may contribute to theendothelial dysfunction and atherosclerosis, are investigated.No relationship was found between IGF-I and NO, ET-I,high sensitive CRP (hs-CRP)and lipid levels. But in the IGF-I higher group there was positive correlation between NO andTriglyceride (TG) and Very-Low-Density Lipoprotein Cholesterol (VLDL-C). Also contraryto litheratur findings, in the IGF-I lower group there was significantly positive correlationbetween NO and insulin resistance and also in this group significantly relationship betweenNO and Low-Density Lipoprotein Cholesterol (LDL-C), VLDL-C, TG and total cholesterol.These findings considered us, especially in the early state NO can increase as a defense mechanism secondary to increase of cardiovascular risk factors. No correlation was foundbetween IGF-I and hs-CRP, fibrinogen and lipid levels, but in the IGF-I lower group hs-CRPand fibrinogen were higher than the other two groups. Additionally in the IGF-I lower groupwe determined positive correlation between ET-I and hs-CRP. These findings considered us,reduction of IGF-I levels contribute to atherosclerosis by these marksers. Original finding ofour study was, significant correlation between insulin resistance and body mass index.Consequently, it is considered that reduction of IGF-I may contribute to early state ofatherosclerosis, but to bring out the real risk these people must be followed for a long period.
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