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Hemodiyaliz Hastalarında HCV Enfeksiyonunun Serum Lipid Profili Üzerine Etkileri

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The Effects of HCV Infection on Serum Lipid Profile in Hemodialysis Patients

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Sayfa Aralığı:: 
40-45

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Abstract (Original Language): 
Amaç: Hemodiyaliz (HD) hastalarında hepatit C virüs (HCV) enfeksiyonunun serum lipid düzeyleri üzerine etkilerini araştırmak. gereç ve yöntem: Çalışmaya iki aydan uzun süredir HD tedavisi gören 108 hasta dahil edildi. Hastalar HCV pozitif ve negatif omak üzere iki gruba ayrıldı. Her iki grubun serum total kolesterol (TK), trigliserid (TG), yüksek yoğunluklu lipoproteinler (HDL), düşük yoğunluklu lipoprotein (LDL), ve çok düşük yoğunluklu lipoprotein (VLDL) düzeyleri karşılaştırıldı. Bulgular: Olgularımızın 55’i (%58 E) anti-HCV (-) ve 53’ü (%64 E) anti-HCV(+) idi. Anti- HCV(-) grubun yaş ortalaması 43±16 yıl ve HD süresi 20±16 ay iken anti-HCV(+) grupta bu değerler sırası ile 43±14 yıl ve 50±32 ay idi. Yaş ve cinsiyet yönünden her iki grup benzer iken HCV(+) grupta HD süresi daha uzun idi (p<0,0001). Hastaların TK düzeyleri karşılaştırıldığında anti-HCV(-) grupta 148±42 mg/dl iken anti-HCV(+) grupta 129±27 mg/dl idi. Gruplar arasındaki fark anlamlı idi (p=0,006). Anti-HCV negatif grupta TG düzeyleri 162±64 mg/dl iken anti-HCV pozitif grupta 137±55 mg/dl saptandı. Her iki grup arasındaki fark istatistiksel olarak anlamlı bulundu (p=0,032). Anti-HCV(-) grupta ortalama HDL düzeyleri 36±11mg/dl iken anti-HCV(+) grupta 32±11 mg/dl idi. Her iki grup arasındaki fark istatistiksel olarak anlamlı idi (p=0,036). Her iki grubun hem LDL hem de VLDL düzeyleri arasında istatistiksel olarak anlamlı fark saptanmadı. Çalışmamızda, serum ALT düzeyleri ile serum lipid düzeyleri arasında herhangi bir istatistiksel ilişki saptanmazken; serum AST düzeyleri ile TK, TG ve HDL düzeyleri arasında anlamlı korelasyon saptandı. Serum AST değeri >30 iü/dl ve <30 iü/dl olan hastalar karşılaştırıldığında ortalama serum TK, TG ve VLDL düzeyleri, AST >30 olan grupta istatistiksel olarak anlamlı derecede daha düşük saptandı. SONUÇ: Hemodiyalize giren HCV (+) hastalarda serum TK, TG ve HDL düzeyleri HCV (-) hastalara göre daha düşüktür. Serum AST düzeyleri arttıkça TK, TG ve VLDL düzeyleri azalma eğiliminde idi.
Abstract (2. Language): 
Objective: We aimed to investigate effects of hepatitis C virus infection on serum lipid profile in hemodialyzed patients. Method: The serum lipid profile was determined in 108 patients who had been on regular hemodialysis for at least two months. Serum total cholesterol (TC), triglyceride (TG), HDL (high density lipoprotein), VLDL (very low density lipoprotein) and LDL (low density lipoprotein) levels were compared between two groups. Result s: The study included 55 HCV-negative (%58 male) and 53 HCV-positive (%64 male) hemodialysed patients. Mean age was 43±16 years in the HCV-negative group and 43±14 years in the HCV-positive group. There were no significant differences between the two groups with respect to age and gender. Mean duration of HD was 20±16 months in the HCV (-) group and 50±32 months in the HCV (+) group. Mean hemodialysis time was longer in HCV (+) patients than HCV (-) patients (p<0.0001). Mean serum TC (129±27 vs 148±42 mg/dL; p=0.006), TG (137±55 vs 162±64 mg/dL; p=0.032), and HDL levels (32±11 vs 36±11 mg/dL; p=0.036) were significantly lower in the HCVpositive group than in the HCV-negative group. Mean serum LDL and VLDL levels were similar in the two groups. Although we did not find a statistical difference between serum lipid levels and ALT levels; there was a statistically significant correlation between serum AST level and TC, TG, and VLDL-c levels. Serum TC, VLDL levels were significantly higher in patients with AST >30 iu/dL than in patients with AST <30 iu/dL. Conclusion: The present study suggests that HCV infection is associated with lower TC, TG and VLDL-c levels in hemodialysed patients. An increase in serum AST levels was associated with a decrease in lipid levels.

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DOI: 
10.5262/tndt.2010.1001.06

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