Nullipar ve multipar gebelerde obezitenin PROBNP, lipit parametreleri ve oksidatif stres üzerine etkilerinin değerlendirilmesi
Evaluation of effect of obesity on PROBNP, lipid parameters and oxidative stress in nullipar and multiparous pregnancy
Yazar: IŞIL YAVRU
Danışman: DOÇ. DR. KÖKSAL DEVECİ ; YRD. DOÇ. DR. ZELİHA CANSEL ÖZMEN
Tokat Gaziosmanpaşa Üniversitesi / Sağlık Bilimleri Enstitüsü / Tıbbi Biyokimya Ana Bilim Dalı
Derece: Yüksek Lisans, 2019
Konu: Biyokimya = Biochemistry
Dizin: Antioksidanlar = Antioxidants ; Gebelik = Pregnancy ; Natriüretik ajanlar = Natriuretic agents ; Obezite = Obesity ; Oksidanlar = Oxidants ; Oksidatif stres = Oxidative stress ; Vücut kitle indeksi = Body mass index

Özet:
Son zamanlarda obezite tüm dünyada sıklığı giderek artan önemli bir halk sağlığı sorunu haline gelmiştir. Maternal obezite, nesiller arası bir obezite döngüsünü teşvik eden, yenidoğanlarda advers metabolik etkilerle ilişkilidir. Bu çalışmada, gebelik sayısının obeziteyi etkileyip etkilemediğini ve aynı zamanda tek gebelik ve 2' den fazla gebeliği olanlarda obezitenin serum lipid, total oksidatif stres ve brain natriüretik peptid (PROBNP) düzeyleri üzerine etkisi olup olmadığını araştırmayı amaçladık. 
Çalışmamızda, Amasya Sabuncuoğlu Şerefeddin Eğitim Araştırma Hastanesi Kadın Doğum Kliniğine gelen gönüllülerden kan örnekleri alındı. Vücut kitle indeksine göre obezite kriterleri normal kilolu (VKİ = 18,5–24), fazla kilolu (25 ≤ VKİ <30) ve obez (VKİ ≥ 30) obez olarak belirlendi. Çalışmaya katılan gönüllülerden 20' si normal kilolu, 20' si fazla kilolu ve 40' ı obez olacak şekilde 80 gönüllü gebeden oluşturuldu. Gönüllülerden sarı kapaklı plastik jelli tüplere ~ 5 ml alınan kan örnekleri santrifüj edilerek serumları ayrıldı. Çalışma yapılıncaya kadar -20ºC' de saklandı. Yeteri hasta sayısına ulaşılınca örnekler -20ºC'den çıkartılıp, çözüldükten sonra tek seferde Roche cobas Elecsys marka PROBNP (beyin natriüretik peptid), lipid paneli, TAC(total antioksidan kapasite) ve TOS (total oksidatif stres) Roche cobas 6000 isimli cihazda serum düzeyleri ölçüldü. 
Bel, kalça, PROBNP, TAC, gebelik sayısı bakımından nullipar ve multipar grupları arasında istatistiksel olarak anlamlı bulundu (p  0.05). LDL, HDL, VLDL, TG, TOS ve Oksidatif Stres İndeksi (OSİ) parametreleri açısından gruplar arasındaki fark anlamlı bulunmadı (p>0.05).
Obez multipar gebelerde, nullipar obez olmayan gebelere kıyasla PROBNP ve TAC değerleri düşük, TOS, bel, kalça ölçümleri ve yaşları yüksek bulunmuştur. Nullipar ve multipar gebeler arasında LDL, HDL, VLDL, TG, TAC ve TOS, OSİ parametreleri arasında istatistiksel olarak anlamlı fark gözlenmemiştir (p>0.05). 
Araştırmamızın sonuçları bize multiparite ve obezitenin gebelerde PROBNP değerinde azalmaya neden olabileceğini düşündürdü.

Abstract:
Recently, obesity has become an important public health problem with increasing frequency all over the world. Maternal obesity is associated with adverse metabolic effects in offspring, which promotes an intergenerational cycle of obesity. In this study, we aimed to determine whether the number of pregnancies affects obesity and whether obesity has an effect on serum lipid, total oxidative cytres and brain natriuretic peptide (PROBNP) levels in women with single pregnancy and more than 2 pregnancies.
 In our study, blood samples were collected from volunteers who came to Amasya Sabuncuoğlu Şerefeddin Training and Research Hospital Gynecology Department. According to body mass index, obesity criteria were determined as normal weight (BMI = 18.5–24), overweight (25 ≤ BMI <30) and obese (BMI ≥ 30). 80 volunteers were included in the study, 20 of whom were normal weight, 20 were overweight and 40 were obese. ~  5 ml blood samples taken from the volunteers in yellow-cap plastic gel tubes were centrifuged and  separated. It was stored at -20ºC until the study. When sufficient number of patients were reached, the samples were removed from -20ºC and thawed, then Roche cobas Elecsys brand PROBNP (brain natriuretic peptide), lipid panel, TAC (total antioxidant capacity) and TOS (total oxidative stress) serum levels were measured in Roche cobas 6000 device. 
           There was a statistically significant difference between waist, hip, PROBNP, TAC, nulliparous and multiparous groups (p˂0.05). No statistically significant difference was observed between LDL, HDL, VLDL, TG, OSI and TOS parameters (p>0.05).
         PROBNP and TAC values were low, TOS, waist, hip measurements and age were higher in obese multiparous women compared to non-nulliparous pregnant women. No statistically significant difference was observed between nulliparous and multiparous pregnants between LDL, HDL, VLDL, TG, TAC and TOS and OSI parameters (p>0.05)
Results of our research that multiparity and obesity can cause reduction of PROBNP value in pregnant women.
Key words: Multiparous, Brain Natriuretic Peptide, Total Antioxidant capacity, Total Oxidative Stress, Body Mass Index

Recently, obesity has become an important public health problem with increasing frequency all over the world. Maternal obesity is associated with adverse metabolic effects in offspring, which promotes an intergenerational cycle of obesity. In this study, we aimed to determine whether the number of pregnancies affects obesity and whether obesity has an effect on serum lipid, total oxidative cytres and brain natriuretic peptide (PROBNP) levels in women with single pregnancy and more than 2 pregnancies.
         In our study, blood samples were collected from volunteers who came to Amasya Sabuncuoğlu Şerefeddin Training and Research Hospital Gynecology Department. According to body mass index, obesity criteria were determined as normal weight (BMI = 18.5–24), overweight (25 ≤ BMI <30) and obese (BMI ≥ 30). 80 volunteers were included in the study, 20 of whom were normal weight, 20 were overweight and 40 were obese. ~  5 ml blood samples taken from the volunteers in yellow-cap plastic gel tubes were centrifuged and  separated. It was stored at -20ºC until the study. When sufficient number of patients were reached, the samples were removed from -20ºC and thawed, then Roche cobas Elecsys brand PROBNP (brain natriuretic peptide), lipid panel, TAC (total antioxidant capacity) and TOS (total oxidative stress) serum levels were measured in Roche cobas 6000 device. 
           There was a statistically significant difference between waist, hip, PROBNP, TAC, nulliparous and multiparous groups (p˂0.05). No statistically significant difference was observed between LDL, HDL, VLDL, TG, OSI and TOS parameters (p>0.05).
         PROBNP and TAC values were low, TOS, waist, hip measurements and age were higher in obese multiparous women compared to non-nulliparous pregnant women. No statistically significant difference was observed between nulliparous and multiparous pregnants between LDL, HDL, VLDL, TG, TAC and TOS and OSI parameters (p>0.05)
Results of our research that multiparity and obesity can cause reduction of PROBNP value in pregnant women.
Key words: Multiparous, Brain Natriuretic Peptide, Total Antioxidant capacity, Total Oxidative Stress, Body Mass Index

EVALUATION OF EFFECT OF OBESİTY ON PROBNP, LIPID PARAMETERS AND OXIDATIVE STRESS IN NULLIPAR AND MULTIPAROUS PREGNANCY
ABSTRACT
    Recently, obesity has become an important public health problem with increasing frequency all over the world. Maternal obesity is associated with adverse metabolic effects in offspring, which promotes an intergenerational cycle of obesity. In this study, we aimed to determine whether the number of pregnancies affects obesity and whether obesity has an effect on serum lipid, total oxidative cytres and brain natriuretic peptide (PROBNP) levels in women with single pregnancy and more than 2 pregnancies.
         In our study, blood samples were collected from volunteers who came to Amasya Sabuncuoğlu Şerefeddin Training and Research Hospital Gynecology Department. According to body mass index, obesity criteria were determined as normal weight (BMI = 18.5–24), overweight (25 ≤ BMI <30) and obese (BMI ≥ 30). 80 volunteers were included in the study, 20 of whom were normal weight, 20 were overweight and 40 were obese. ~  5 ml blood samples taken from the volunteers in yellow-cap plastic gel tubes were centrifuged and  separated. It was stored at -20ºC until the study. When sufficient number of patients were reached, the samples were removed from -20ºC and thawed, then Roche cobas Elecsys brand PROBNP (brain natriuretic peptide), lipid panel, TAC (total antioxidant capacity) and TOS (total oxidative stress) serum levels were measured in Roche cobas 6000 device. 
           There was a statistically significant difference between waist, hip, PROBNP, TAC, nulliparous and multiparous groups (p˂0.05). No statistically significant difference was observed between LDL, HDL, VLDL, TG, OSI and TOS parameters (p>0.05).
         PROBNP and TAC values were low, TOS, waist, hip measurements and age were higher in obese multiparous women compared to non-nulliparous pregnant women. No statistically significant difference was observed between nulliparous and multiparous pregnants between LDL, HDL, VLDL, TG, TAC and TOS and OSI parameters (p>0.05)
Results of our research that multiparity and obesity can cause reduction of PROBNP value in pregnant women.
Key words: Multiparous, Brain Natriuretic Peptide, Total Antioxidant capacity, Total Oxidative Stress, Body Mass Index