Nötrofil/lenfosit oranı ve trombosit dağılım hacminin diyabetik nefropati ile ilişkisi
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Tarih
2023
Yazarlar
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Yayıncı
T.C. Maltepe Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
iş ve Amaç: Diyabetik nefropati, diyabetes mellitus’un sık görülen morbidite ve mortalitesi yüksek mikrovasküler bir komplikasyonudur. Diyabetik nefropatinin erken tespiti, bu komplikasyonun gelişmesini önlemeye veya bu komplikasyonun erken tedavi edilmesine yardımcı olacaktır. Bu çalışmada diyabetes mellitus tanılı, nefropatisi olan ( albüminüri >300 mg/24 saat veya >20 ?g/dk ) ve olmayan hastalar arasında trombosit dağılım genişliği ve nötrofil/lenfosit oranı karşılaştırılarak diyabetik nefropati erken tanısında tam kan sayımı parametrelerinin kullanımı amaçlanmaktadır. Gereç ve Yöntem: Ocak 2017- Ocak 2023 tarihleri arasında T.C. Maltepe Üniversitesi Hastanesi İç hastalıkları ve Kardiyoloji Kliniğinde ayakta veya tedavi almış olan 168 hasta ve 174 kontrol grubu çalışmaya dahil edilmiştir. Hasta grubu diyabetik nefropatisi tanısı alan hastalardan seçilmiş olup , kontrol grubu ise nefropatisi olmayan diyabetik hastalardan seçilmiştir. Çalışmadaki tüm hastalar hastane veri tabanına ait verilere bakılarak retrospektif olarak incelenmiş olup hastaların yaş, cinsiyet, kullandığı ilaçlar, komorbid hastalıkları, serum kreatinin,serum albümin, spot idrar mikroalbümin/kreatinin oranı, Hba1c, açlık serum glukoz, hemoglobin, MCV( Ortalama eritrosit hacmi) ,RDW-CV (Eritrosit dağılım genişliği),trombosit, MPV(Ortalama trombosit hacmi) ,PDW(Trombosit dağılım hacmi) ve NLR(Nötrofil/Lenfosit oranı) değerleri takip formlarına kayıt edilmiştir. İstatistiksel Analiz: Çalışmada elde edilen bulgular değerlendirilirken, istatistiksel analizler için IBM SPSS Statistics 26 (IBM SPSS, Türkiye) programı kullanıldı. Anlamlılık p< 0.05 düzeyinde değerlendirilmiştir. Bulgular: Çalışmaya 168’i diyabetik nefropati tanılı hasta, 174’ü diyabetik nefropati olmaksızın Tip 2 DM tanılı kontrol grubu olmak üzere toplam 342 hasta dahil edilmiştir. Genel olarak çalışmaya katılan kadın hastaların oranı %45,3, erkek hastaların oranı %54,7’dir. Kadın ve erkek oranı kontrol ve vaka grubunda benzerdir. Tüm katılımcıların yaş ortalaması ise 65,3 olarak hesaplanmıştır. Vaka grubunun NLR sonucu ortalaması 2,99±2,55 olarak hesaplanmıştır. Kontrol grubunun NLR sonuç ortalaması ise 2,07±1,21 olarak hesaplanmıştır p: <0,001 olup iki grup arasında istatistiksel olarak anlamlı fark bulunmuştur. İki grup arasında MPV ve PDW değerleri karşılaştırılmış olup p değeri sırasıyla 0,878 ve 0,249 olarak hesaplanmıştır ve istatistiksel olarak anlamlı fark bulunamamıştır. Tartışma ve Sonuç: NLR düzeyi hasta grubunda kontrol grubuna kıyasla anlamlı olarak daha yüksek bulunmuştur. Literatür de göz önüne alındığında; NLR’nin diyabetik nefropatinin erken tespitine olanak sağlayacak bir belirteç olarak kullanılabileceği gösterilmiştir. MPV ve PDW değerlerinin biyobelirteç olarak kullanılabilmesi için daha çok literatüre ihtiyaç vardır.
Introduction and Aim: Diabetic nephropathy is a common microvascular complication of diabetes mellitus with high mortality. Early detection of diabetic nephropathy will allow prevention or early treatment of diabetic nephropathy. This study aims to use complete blood count parameters in the early diagnosis of diabetic nephropathy by comparing platelet distribution width and neutrophil/lymphocyte ratio between patients diagnosed with diabetes mellitus, with and without nephropathy (albuminuria >300 mg/24 hours or >20 ?g/min). Materials and Methods: Between January 2017 and January 2023, 168 patients and 174 control groups who were outpatients or treated at Maltepe University Hospital Internal Medicine and Cardiology Clinic were included in the study. The patient group was selected from patients diagnosed with diabetic nephropathy, and the control group was selected from diabetic patients without nephropathy. All patients in the study were examined retrospectively by looking at data from the hospital database. Patients' age, gender, medications used, comorbid diseases, serum creatinine, serum albumin, spot urine microalbumin/creatinine ratio, Hba1c, fasting serum glucose, hemoglobin, MCV (Mean Corpuscular Volume), RDW- CV (Red Cell Distribution Width-Coefficient of Variation), platelet, MPV( Mean Platelet Volume), PDW(Platelet Distribution Width) and NLR (Neutrophil to lymphocyte ratio) values were recorded on follow-up forms. Results: A total of 342 patients were included in the study, 168 patients diagnosed with diabetic nephropathy and 174 patients in the control group diagnosed with Type 2 DM without diabetic nephropathy. Overall, the rate of female patients participating in the study was 45.3% and the rate of male patients was 54.7%. The ratio of men and women is similar in the control and case groups. The average age of all participants was calculated as 65.3.The mean NLR result of the case group was calculated as 2.99±2.55. The NLR result average of the control group was calculated as 2.07±1.21, p: <0.001 and a statistically significant difference was found between the two groups. MPV and PDW values were compared between the two groups, and the p value was calculated as 0.878 and 0.249, respectively, and no statistically significant difference was found. Discussion and Conclusion: NLR level was found to be significantly higher in the patient group compared to the control group. Considering the literature; We showed that NLR can be used as a marker that will allow early detection of diabetic nephropathy. More literature is needed to use MPV and PDW values as biomarkers.
Introduction and Aim: Diabetic nephropathy is a common microvascular complication of diabetes mellitus with high mortality. Early detection of diabetic nephropathy will allow prevention or early treatment of diabetic nephropathy. This study aims to use complete blood count parameters in the early diagnosis of diabetic nephropathy by comparing platelet distribution width and neutrophil/lymphocyte ratio between patients diagnosed with diabetes mellitus, with and without nephropathy (albuminuria >300 mg/24 hours or >20 ?g/min). Materials and Methods: Between January 2017 and January 2023, 168 patients and 174 control groups who were outpatients or treated at Maltepe University Hospital Internal Medicine and Cardiology Clinic were included in the study. The patient group was selected from patients diagnosed with diabetic nephropathy, and the control group was selected from diabetic patients without nephropathy. All patients in the study were examined retrospectively by looking at data from the hospital database. Patients' age, gender, medications used, comorbid diseases, serum creatinine, serum albumin, spot urine microalbumin/creatinine ratio, Hba1c, fasting serum glucose, hemoglobin, MCV (Mean Corpuscular Volume), RDW- CV (Red Cell Distribution Width-Coefficient of Variation), platelet, MPV( Mean Platelet Volume), PDW(Platelet Distribution Width) and NLR (Neutrophil to lymphocyte ratio) values were recorded on follow-up forms. Results: A total of 342 patients were included in the study, 168 patients diagnosed with diabetic nephropathy and 174 patients in the control group diagnosed with Type 2 DM without diabetic nephropathy. Overall, the rate of female patients participating in the study was 45.3% and the rate of male patients was 54.7%. The ratio of men and women is similar in the control and case groups. The average age of all participants was calculated as 65.3.The mean NLR result of the case group was calculated as 2.99±2.55. The NLR result average of the control group was calculated as 2.07±1.21, p: <0.001 and a statistically significant difference was found between the two groups. MPV and PDW values were compared between the two groups, and the p value was calculated as 0.878 and 0.249, respectively, and no statistically significant difference was found. Discussion and Conclusion: NLR level was found to be significantly higher in the patient group compared to the control group. Considering the literature; We showed that NLR can be used as a marker that will allow early detection of diabetic nephropathy. More literature is needed to use MPV and PDW values as biomarkers.
Açıklama
Anahtar Kelimeler
Diyabetes mellitus, Diyabetik nefropati, Diyabetik Böbrek Hastalığı, Trombosit dağılım hacmi, Nötrofil/lenfosit Oranı, Kardiyovasküler olay, Biyobelirteç, Diabetes mellitus, Diabetic nephropathy, Diabetic kidney disease, Platelet distribution volume, Neutrophil/lymphocyte ratio, Cardiovascular event, Biomarker
Kaynak
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Künye
Kenan, A. N. (2023). Nötrofil/lenfosit oranı ve trombosit dağılım hacminin diyabetik nefropati ile ilişkisi. (Yayımlanmamış Tıpta Uzmanlık Tezi). Maltepe Üniversitesi, Tıp Fakültesi, İstanbul.
