Ankara Med J. 2020; 20(4): 844-857 | DOI: 10.5505/amj.2020.93276

Koroner Arter Hastalýðý Riskini Öngörmede Major Risk Faktörleri ve Metabolik Sendrom Kriterlerinin Deðerlendirilmesi

Nagihan Beþtepe¹, Ömer Dönderici², Burcu Demirkan^3
1Ankara Þehir Hastanesi, Endokrinoloji ve Metabolizma Hastalýklarý Kliniði, Ankara
²Ankara Eðitim ve Araþtýrma Hastanesi, Ýç Hastalýklarý Kliniði, Ankara
³Ankara Þehir Hastanesi, Kardiyoloji Kliniði, Ankara

GÝRÝÞ ve AMAÇ: Metabolik sendrom (MS) kavramý, temelinde yatan insülin direnci (ÝR) ve kardiyovasküler hastalýða ait risk faktörlerinin kümelenmesi nedeni ile kritik bir öneme sahiptir. Biz bu çalýþmamýzda geleneksel kardiyovasküler risk faktörlerinin yanýnda MS kriterlerinin kardiyovasküler riski öngörmedeki deðerini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Çalýþma tanýsal amaçla koroner anjiyografi (KAG) yapýlan 264 hasta üzerinde yapýlmýþtýr. KAG sonucuna göre bir veya daha fazla koroner arterinde anlamlý daralma saptanan olgular koroner arter hastalýðý (KAH) grubu ve herhangi bir daralmanýn saptanmadýðý olgular ise kontrol grubu olarak kabul edildi. KAH ve kontrol grubu, klasik risk faktörleri ve MS kriterleri açýsýndan karþýlaþtýrýldý. Hastalarda klasik risk faktörleri ve MS parametreleri regresyon analizi ile deðerlendirilerek risk öngörüleri hesaplandý.
BULGULAR: Olgularýn 103’ü kadýn (%39,01) ve 161’i erkekti (%60,98). Kadýn olgularýn yaþ ortalamasý 57,91±9,97 ve erkek olgularýn yaþ ortalamasý 58,63±10,21 bulundu. MS kriterlerinin görülme sýklýðýna bakýldýðýnda kadýnlarda bel çevresi (BÇ) yüksekliði, erkeklerde HDL-K düþüklüðü ve her iki cinste TG yüksekliði ön planda idi. MS, KAH riskini öngörmede anlamlý deðildi ancak BÇ’deki her 1 cm lik geniþleme, her iki cinste de KAH riskinde artýþla ve kalça çevresindeki (KÇ) her 1 cm lik artýþ ise KAH riskinde azalma ile sonuçlandý.
TARTIÞMA ve SONUÇ: Çalýþmamýzda MS’un kadýnlarda yüksek BÇ ve erkeklerde ise HDL-K düþüklüðü ile birlikte ortaya çýktýðýný gözlemledik. Bu durum düþük HDL-K’nýn etnik özelliðimiz olduðu varsayýmýný desteklemekle birlikte toplumumuzda kardiyovasküler olaylarla yakýndan iliþkili MS kriterlerini belirlemek için, özellikle de HDL-K ve BÇ açýsýndan yeni çalýþmalara ihtiyaç olduðunu göstermektedir.

Anahtar Kelimeler: Koroner arter hastalýðý, metabolik sendrom, bel çevresi.

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Evaluation of Major Risk Factors And Metabolic Syndrome Criteria In Predicting Coronary Artery Disease Risk

Nagihan Beþtepe¹, Ömer Dönderici², Burcu Demirkan^3
1Ankara City Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
²Ankara Education and Research Hospital, Department of Internal Medicine, Ankara, Turkey
³Ankara City Hospital, Department of Cardiology, Ankara, Turkey

INTRODUCTION: The concept of metabolic syndrome (MS) is critical due to the underlying insulin resistance (IR) and included risk factors for cardiovascular disease. In this study, we aimed to investigate the value of MS criteria in predicting cardiovascular risk as well as traditional cardiovascular risk factors.
METHODS: The study was performed on 264 patients who underwent coronary angiography (CAG) for diagnostic purposes. According to the CAG result, patients with significant stenosis in one or more coronary arteries were considered the CAD (coronary artery disease) group, and cases without stenosis were accepted as the control group. CAD and control groups were compared in terms of traditional risk factors and MS criteria. The traditional risk factors and MS were evaluated for the patients by regression analysis and risk predictions were calculated.
RESULTS: There were 103(39.01%) female and 161(60.98%) male patients. The mean age was57.91±9.97 in females and 58.63±10.21 in males. Considering the incidence of MS criteria, the elevation of waist circumference(WC) in women, low HDL-C in men, and high TG in both sexes were at the forefront.MS was not significant in predicting CAD risk but every 1 cm increase in WC resulted in increased risk of CAD in both sexes and every 1 cm increase in hip circumference(HC) resulted in decreased risk of CAD.
DISCUSSION AND CONCLUSION: In our study, we observed that MS appeared with high WC in women and low HDL-C in men. While this supports the assumption that low HDL-C is a feature of our ethnicity, new studies are needed to determine MS criteria closely related to cardiovascular events in our society, especially in terms of HDL-C and WC.

Keywords: Coronary artery disease, metabolic syndrome, waist circumference.

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ATIF KOPYALA