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HEMODİYALİZ HASTALARINDA İNSÜLİN DİRENCİ ÜZERİNE PARATHORMONUN ETKİSİ

THE EFFECT OF PARATHYROID HORMONE ON THE INSULIN RESISTANCE IN HEMODIALYSIS PATIENTS

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Abstract (2. Language): 
The purpose of this study was to investigate whether the parathyroid hormone (PTH) level affects insulin resistance in hemodialysis patients. 28 hemodialysis patients were divided into three groups according to their PTH levels as normal, high and very high groups. Intravenous glucose tolerance test lasting 120 minutes was applied to all patients. Glucose and insulin values were determined and the total areas under the curves of glucose and insulin were calculated. We did not find a significant difference between the stimulated glucose levels of each group. But insulin responses of group with very high PTH levels were significantly higher than those of the groups with normal and high PTH levels. Although there was no difference between total areas under glucose curves of three groups, total area under insulin curve of the group with very high PTH level was higher than those of other groups. The results suggest that the moderately high PTH level in hemodialysis patients does not affect insulin resistance and insulin release from the pancreas independent of the calcium, ionized calcium and phosphate levels. In addition, we came to the conclusion that the very high PTH levels increased insulin resistance by elevating the insulin levels.
Abstract (Original Language): 
Bu çalışma paratiroid hormon (PTH) seviyelerinin hemodiyaliz hastalarında insülin direnci üzerine etkisinin araştırılması amacıyla planlanmıştır. 28 hemodiyaliz hastası PTH seviyelerine göre normal, yüksek ve çok yüksek olmak üzere 3 gruba ayrüddar. Tüm hastalara 120 dakikalık sık örneklemeıi intravenöz glikoz tolerans testi (İVGTT) yapıldı. Senim glikoz ve insülin değerleri ve insülin ve glikoz eğrilerinin altındaki total alanlar hesaplandı. IVGTT'ne her üç grubun glikoz cevapları arasında anlamlı bir fark bulunmadı. F.akat çok yüksek PTH düzeyli gruptaki insülin cevapları normal vö yüksek PTH seviyeli gruplara göre anlamlı yüksekti. Her üç grubun glikoz eğrileri altında kalan total alanlar arasında anlamlı bir fark olmamasına karşın, sadece çok yüksek PTH düzeyli grubun insülin eğrisi altında kalan alan diğer gruplardan anlamlı olarak daha yüksekti. Bu sonuçlar, hemodiyaliz hastalarında orta derecede yüksek PTH düzeylerinin, kalsiyum, iyonize kalsiyum ve fosfat seviyelerinden bağımsız olarak insülin direncini ve pankreastan insülin salınımını etkilemediğini düşündürmektedir. Ayrıca, çok yüksek PTH düzeylerinin insülin seviyelerini yükselterek insülin direncini artırdığı kanaatine vardık.
FULL TEXT (PDF): 
168-172

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