Diabetes mellituslu hastalarda, diabet eritrosit membranı Na+ -K+ ATPaz enzim aktivitesi, MDA, DHEAS ve lipidler üzerine etkisinin araştırılması

Abstract

6. ÖZET DİABETES MELLİTUS' LU HASTALARDA, DİABET YILININ ERİTROSİT ZARI Na+-K* ATPaz ENZİM AKTİVİTESİ, MDA, DHEAS VE LİPİDLER ÜZERİNE ETKİSİNİN ARAŞTIRILMASI Diabetes Mellitus'un lipid peroksidasyonu, hücresel yaşlanma ve eritrosit membranı üzerindeki etkisini görmek amacıyla Konya ve çevresinde yaşayan 22- 72 yaşlan arasında 38 (19 E, 19 K) 0-5 yıldır diabeti olan, 31-77 yaşları arasında 40 (18E, 22 K) 6-10 yıldır diabeti olan, 34-70 yaşları arasında 27 (12 E, 15 K) 11 ve daha fazla yıldır diabeti olan, 35-77 yaşları arasında 54 (20E, 34 K) sağlıklı kontrol vakalarında akş, plazma MDA, serum DHEAS, trigliserid, total kolesterol ve eritrosit membranı Na+-K` ATPaz enzim aktiviteleri ölçüldü. Açlık kan şekeri, plazma MDA, serum DHEAS E, serum DHEAS K, trigliserid, total kolesterol ve Na+-K* ATPaz değerleri kontrol vakalarında sırasıyla 97,53 ± 9,09 mg/dl, 5,69 ± 0,62 nmol/ml, 196,64 ± 173,65 ug/ml, 163,71 ± 118,76 ug/ml, 126,29 ± 48,87 mg/dl, 186,88 ± 44,29 mg/dl, 4,15 ± 0,28 umol Pi/mg prt/10 dk, 0-5 yıldır hasta olanlarda 197,26 ± 75,23 mg/dl, 6,13 ± 0,16 nmol/ml, 157,58 ± 95,38 ug/ml, 124,29 ± 71,66 ug/ml, 204,07 ± 87,66 mg/dl, 208,00 ± 44,39 mg/dl, 3,93 ± 0,38 umol Pi/mg prt/10 dk, 6-10 yıldır hasta olanlarda 198,50 ±59,12 mg/dl, 6,38 ± 0,36 nmol/ml, 168,39 ±86,16 ug/ml, 140,88 ± 91,77 ug/ml, 196,13 ± 124,38 mg/dl, 203,12 ± 32,91mg/dl, 3,82 ± 0,32 umol pj/mg prt/10 dk, 11 ve daha fazla yıldır hasta olanlarda 212,44 ±56,13 mg/dl, 6,76 ± 0,47 nmol/ml, 143,85 ± 55,57 ug/ml, 107,20 ± 87,60 ug/ml, 209,96 ± 94,18 mg/dl, 215,25 ± 38,59 mg/dl, 3,83 ± 0,33 umol Pi/mg prt/10 dk ölçülerek, ortalama ± standart sapma olarak gösterildi. Bu bulgulardan yola çıkarak diabetli hastalarda kontrol grubuna göre kan şekeri, plazma MDA düzeyi, trigliserid (p=0,000) ve total kolesterol (p=0,002) seviyeleri anlamlı şekilde yüksek, DHEAS (p>0,05) ve Na+-K* ATPaz düzeyi (p=0,000) ise düşük bulundu. Yaşla MDA artmakta (p=0,029) ve DHEAS ise azalmaktadır (p=0,002). Hastalık süresi ile MDA arasında anlamlı pozitif bir korelasyon vardı (p=0,000). Glukoz düzeyi ve hastalık süresi ile Na+-K* ATPaz enzim aktivitesi arasında negatif bir ilişki vardı, fakat istatistiksel olarak anlamlı değildi (p>0,05). Sonuç olarak diabette serbest radikaller ve hücre yaşlanması artmakta, eritrosit membranında değişiklikler olmakta ve diabetin kronik komplikasyonlarına eğilim artmaktadır. 66

7. SUMMARY AN INVESTIGATION OF DIABETIC YEAR'S EFFECT ON ERYTHROCYTE MEMBRANE'S Na+-K* ATPase ENZYME ACTIVITY, MDA, DHEAS AND LIPIDS IN THE DIABETES MELLITUS PATIENTS To see the effect of Diabetes Mellitus (DM) on lipid peroxidation, cell ageing and erythrocyte membrane, we measured fasting glucose, serum DHEAS, triglyceride, total cholesterol and erythrocyte membrane's Na+-K* ATPase enzyme activity on the people who are living in the city center and around Konya/Turkey. The distribution of studied patients was as follows: 22-72 years old 38 patients (19 male (M), 19 female (F)) who are with DM for 0-5 years, 31-77 years old 40 patients (18 M, 22 F) who are with DM for 6-10 years, 34-70 years old 27 patients (12 M, 15 F) who are with DM for 11 and over years and 35-77 years old 54 healthy control individuals (20 M, 34 F). After measurement statistical analysis was performed and the results were given with mean ± standard deviation. The results of studied parameter which are fasting glucose, plasma MDA, serum DHEAS male, serum DHEAS female, triglyceride, total cholesterol and Na+- K* ATPase values were giving respectively below regarding to the study groups; in case control group: 97,53 ± 9,09 mg/dl, 5,69 ± 0,62 nmol/ml, 196,64 ± 173,65 ug/ml, 163,71 ± 1 18,76 ug/ml, 126,29 ± 48,87 mg/dl, 186,88 ± 44,29 mg/dl, 4,15 ± 0,28 umol Pi/mg protein/10 min, the result of patients who have DM for 0-5 years: 197,26 ± 75,23 mg/dl, 6,13 ± 0,16 nmol/ml, 157,58 ± 95,38 ug/ml, 124,29 ± 71,66 ug/ml, 204,07 ± 87,66 mg/dl, 208,00 ± 44,39 mg/dl, 3,93 ± 0,38 umol Pi/mg protein/10 min, the result of patients who have DM for 6-10 years: 198,50 ±59,12 mg/dl, 6,38 ± 0,36 nmol/ml, 168,39 ±86,16 ug/ml, 140,88 ± 91,77 ug/ml, 196,13 ±124,38 mg/dl, 203,12 ± 32,91 mg/dl, 3,82 ± 0,32 umol Pi/mg protein/10 min, the result of patients who have DM for 11 and over 11 years: 212,44 ±56,13 mg/dl, 6,76 ± 0,47 nmol/ml, 143,85 ± 55,57 ug/ml, 107,20 ± 87,60 ug/ml, 209,96 ±94,18 mg/dl, 215,25 ± 38,59 mg/dl, 3,83 ± 0,33 umol Pi/mg protein/10 min. Regarding to these results, in the patients who have DM, fasting glucose, the plasma MDA level, triglyceride (p=0,000) and the total cholesterole (p=0,002) levels were found significantly increased for control group. DHEAS (p>0,05) and Na+-K* ATPase levels (p=0,000) were found significantly decreased for control group. MDA was increasing with age (p=0,029) but, DHEAS was decreasing (p=0,002). There was a significantly positive correlation between the period of DM and MDA (p=0,000). There was a negative correlation between glucose level and DM period with Na+-K* ATPase activity but it was not significantly (p>0,05). Regarding to the present study results, as an effect of DM the increase in the level of free radicals was found. In the literature, it is reported that the increase in the level of the free radicals cause to cell ageing. In addition to this there was some change in erythrocyte membrane and tendency to the chronic complications of DM were increasing. 67