İnsüline bağımlı olmayan diabetik hastalarda serum siyalik asit düzeyinin kan basıncı ve retinopatiyle ilişkisi
Serum sialic acid concentrations in patients with non-insulin dependet diabetes mellitus and it`s relationship to blood pressure and retinopathy
Yazar: AHMET ERDİL
Danışman: PROF.DR. FİKRİ KOCABALKAN
GATA / Tıp Fakültesi / İç Hastalıkları Ana Bilim Dalı
Derece: Tıpta Uzmanlık, 1994
Konu: Endokrinoloji ve Metabolizma Hastalıkları = Endocrinology and Metabolic Diseases
Dizin: Diabetes mellitus-tip 2 = Diabetes mellitus-type 2 ; Diabetik retinopati = Diabetic retinopathy ; Kan basıncı = Blood pressure ; Lipidler = Lipids ; Siyalik asitler = Sialic acids

Özet:
SUMMARY Serum Sialic Acid Concentrations in Patients with Non-Insulin Dependent Diabetes Mellitus and It's Relationship to Blood Pressure and Retinopathy. In the formation of diabetic retinopathy that is an important complication of diabetes mellitus, it is supposed that together with high blood glucose the increasing sialic acid in diabetes mellitus plays an important role. In this study, we investigated serum total sialic acid levels relate to glysemic control, blood pressure, retinopathy and serum lipid levels in diabetic patients. We selected 62 patients with type II diabetes mellitus as a research group and after fundoscopic examinations they were classified in two groups. 31 patients did not have any retinopathy and any other complications, in the other group 20 patients had background retinopathy, 1 1 patients had background retinopathy and maculopathy. 35 of the studied patients were female, 27 of them were male, having ages ranging from 41 to 74. While 23 patients had less than 5 years of diabetic duration, 39 of them had 5 or over 5 years. We selected 31 normal (healthy) subjects at random and matched them for age and sex with patients. Serum total sialic acid levels in the patients were found significantly higher than normal subjects (p<0.001). Serum sialic acid levels were especially elevated in patients with diabetic retinopathy when compared to the group without retinopathy (p<0.01). There were correlation's between serum fructosamin levels and total serum sialic acid levels of the patients (p<0.001,p<0.05). In the patients without retinopathy, we found high correlation between serum sialic acid levels and systolic blood pressure and erythrocyte sedimentation rate (p<0.001), but we found a less correlation between plasma glucose and diastolic blood pressures (p<0.01). In the patients with retinopathy, a high correlation between plasma glucose and total serum sialic acid levels (p<0.001), a less correlation between erythrocyte sedimentation rate, systolic and diastolic blood pressures were found (p<0.01). There were no correlation's between sex, age, BMI, serum triglyseride, serum cholesterol, diabetic duration and serum total sialic acid levels in both patient groups (p>0.05). There was no significant relationship of total sialic acid with another parameters in normal subjects (p>0.05). 38As a conclusion, according to this study total serum sialic acid levels are very important in diabetic patients. Gradually increasing silica acid levels in diabetic patients by destroying to the cell structure plays and important role in retinopathy formations. There is a relationship of sialic acid with high blood pressure that has an influence in retinopathy formation. It is possible to prevent excessive increasing of serum sialic acid levels by a good diabetic regulation and keeping blood pressures in normal ranges, thus retinopathy formations can be decreased. To determine the relationship of the sialic acid to warriors' parameters, should be made more studies in larger groups of diabetic patients including insulin dependent diabetic subjects. 39

Abstract:
SUMMARY Serum Sialic Acid Concentrations in Patients with Non-Insulin Dependent Diabetes Mellitus and It's Relationship to Blood Pressure and Retinopathy. In the formation of diabetic retinopathy that is an important complication of diabetes mellitus, it is supposed that together with high blood glucose the increasing sialic acid in diabetes mellitus plays an important role. In this study, we investigated serum total sialic acid levels relate to glysemic control, blood pressure, retinopathy and serum lipid levels in diabetic patients. We selected 62 patients with type II diabetes mellitus as a research group and after fundoscopic examinations they were classified in two groups. 31 patients did not have any retinopathy and any other complications, in the other group 20 patients had background retinopathy, 1 1 patients had background retinopathy and maculopathy. 35 of the studied patients were female, 27 of them were male, having ages ranging from 41 to 74. While 23 patients had less than 5 years of diabetic duration, 39 of them had 5 or over 5 years. We selected 31 normal (healthy) subjects at random and matched them for age and sex with patients. Serum total sialic acid levels in the patients were found significantly higher than normal subjects (p<0.001). Serum sialic acid levels were especially elevated in patients with diabetic retinopathy when compared to the group without retinopathy (p<0.01). There were correlation's between serum fructosamin levels and total serum sialic acid levels of the patients (p<0.001,p<0.05). In the patients without retinopathy, we found high correlation between serum sialic acid levels and systolic blood pressure and erythrocyte sedimentation rate (p<0.001), but we found a less correlation between plasma glucose and diastolic blood pressures (p<0.01). In the patients with retinopathy, a high correlation between plasma glucose and total serum sialic acid levels (p<0.001), a less correlation between erythrocyte sedimentation rate, systolic and diastolic blood pressures were found (p<0.01). There were no correlation's between sex, age, BMI, serum triglyseride, serum cholesterol, diabetic duration and serum total sialic acid levels in both patient groups (p>0.05). There was no significant relationship of total sialic acid with another parameters in normal subjects (p>0.05). 38As a conclusion, according to this study total serum sialic acid levels are very important in diabetic patients. Gradually increasing silica acid levels in diabetic patients by destroying to the cell structure plays and important role in retinopathy formations. There is a relationship of sialic acid with high blood pressure that has an influence in retinopathy formation. It is possible to prevent excessive increasing of serum sialic acid levels by a good diabetic regulation and keeping blood pressures in normal ranges, thus retinopathy formations can be decreased. To determine the relationship of the sialic acid to warriors' parameters, should be made more studies in larger groups of diabetic patients including insulin dependent diabetic subjects. 39