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Yeni Tanı Almış Tip 2 Diyabetli Hastalarda Gündüz, Gece ve 24 Saatlik Nabız Hızları ile İdrar Albumin ve Protein Atılımı Arasındaki İlişki

The Relationship Between Daytime, Nighttime and 24-Hour Heart Rate with Urinary Albumin and Protein Excretion in Patients with Newly Diagnosed Type 2 Diabetes

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DOI: 
DOI 10.5262/tndt.2012.1002.03
Author NameUniversity of Author
Abstract (2. Language): 
OBJECTIVE : Autonomic nervous system dysfunction (ASD) has been widely observed in patients with type 2 diabetes. 24-hour ambulatory blood pressure (ABP) and heart rate measurements have been found to associate with ASD in patient with Type 2 diabetes. Since albumin excretion is also related with ASD in type 2 diabetes; in the current study, the relationships between daytime, nighttime and 24- hour heart rates with 24 hour urinary albumin excretion (UAE) and 24-hour urinary protein excretion (UPE) were analyzed in patients with newly diagnosed type 2 diabetes. MATER IAL and Methods: All patients underwent following procedures: history taking, physical examination, BP measurement, 12 lead electrocardiographic evaluations, routine urine analysis, biochemical analysis, 24-hour urine collection to measure UAE, UPE and creatinine clearance. 24-hour ABP and heart rate monitoring were performed for all patients. Results : In total 80 patients with newly diagnosed type 2 diabetes were included. Stepwise linear regression revealed that logarithmically converted 24-hour UAE were independently related with 24- hour ambulatory SBP, (P:0.001) and heart rate (night) (P<0.0001). Stepwise linear regression revealed that logarithmically converted 24-hour UPE were independently related with age (P:0.032), with averaged fasting blood glucose (P:0.023), with 24-hour ambulatory SBP, (P:0.002) and with heart rate (night) (P:0.001). Conc lusion : Nighttime heart rate, but not daytime and 24-hour heart rate was related with both 24-hour UAE and UPE in patients with Type 2 diabetes
Abstract (Original Language): 
Amaç : Otonomik Sistem İşlev bozukluğu (OSİB) Tip 2 diyabetli hastalarda sık gözlenen bir durumdur. Tip 2 diyabeti olan hastalarda 24 saatlik ayaktan ölçülen nabız hızlarının OSİB ile ilişkili olduğu gösterilmiştir. Bununla birlikte bu hastalarda 24 saatlik idrarda protein atılımının (İPA) ve idrarda albümin atılımının (İAA) OSİB ile ilişkili olduğu bilinmektedir. Bütün bu bilgiler ışığında bu çalışmada yeni tanı almış tip 2 diyabeti olan hastalarda 24 saatlik İPA ve İAA ve gündüz, gece ve 24 saatlik nabız hızları ile olan ilişkisi araştırılmıştır. GERE Ç ve YöntemLER: Bütün hastaların tıbbı öyküleri alındı, fizik muayeneleri yapıldı, kan basınçları ölçüldü, elektrokardiyografileri çekildi, biyokimyasal analizleri yapıldı, rutin idrar incelemeleri yapıldı ve 24 saatlik İAA ve İPA ve kreatinin klirensi hesaplandı. Ayrıca bütün hastalara 24 saatlik kan basınçları (KB) ve nabız hızları ölçüldü. Bulgular: Çalışmaya toplam 80 yeni tanı almış tip 2 diyabetli hasta alındı. Basamaklı doğrusal regresyon analizinde 24 saatlik ayaktan sistolik KB (P:0,001) ve gece nabız hızı (P<0,0001) 24 saatlik İAA’nın bağımsız öngörücüleri olarak bulundu. Basamaklı doğrusal regresyon analizinde yaş (P:0,032), ortalama açlık kan şekeri (P:0,023), 24 saatlik ayaktan sistolik KB (P:0,002) ve gece nabız hızı (P:0,001) 24 saatlik İPA’nın bağımsız öngörücüleri olarak bulundu. Son uç: 24 saatlik veya gündüz nabız hızları değil sadece gece nabız hızı idrarda 24 saatlik protein ve albümin atılımı ile ilişkili bulundu.
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