Diyabetik annelrin 3-?-hidroksibütirat düzeyleri ile bebeklerindeki hematolojik sorunların ilişkisi
Küçük Resim Yok
Tarih
2004
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Diyabetik gebelikteki, fetal anomali ve perinatal mortalite gibi komplikasyonlar son 3 dekadda azalmıştır. Bununla beraber, makrozomi, hipoglisemi, polistemi gibi metabolik bozukluklar diyabetik anne bebekleri için halen önemli sorunlardır. Hem pregestasyonel diyabet hem de gestasyonel diyabet metabolik komplikasyonlara neden olabilmektedir. Polistemik bebeklerde hiperviskozite ve artmış eritrosit kitlesine bağlı olarak, doku hipoksisi, hiperbilirübinemi, hipoglisemi, solunum sıkıntısı, apne, konvülsiyon, böbrek hasarı ve kalp yetmezliği gelişebilir. Polisteminin patogenezi tam olarak anlaşılamamıştır. Ege Üniversitesi Tıp Fakültesi kadın-doğum ve pediyatri kliniklerinde, pregestasyonel ve gestasyonel diyabetli gebeler ve term yenidoğan bebekleri çalışmaya alındı. Annelerde gebeliğin 34-36. haftalarında açlık 3-(3 hidroksibutirat (3-(3HB) ve HbA-ıc düzeyleri ölçüldü. Bebeklerde doğum ağırlığı, apgar skorları, kord kanında serum insülin ve eritropoetin, RBC sayısı, Hb ve HbF düzeyi ile 4. saat venöz Hct çalışıldı. Diyabetik annelerdeki 3-(3HB ve HbAıc düzeyleri kontrol gurubuna göre anlamlı olarak yüksek saptandı(p<0.001,p<0.05). Diyabetik anne bebek lerinde doğum ağırlığı kontrol gurubuna göre anlamlı olarak yüksekti ve makrozomi % 40 oranında gözlendi. Diyabetik anne bebeklerinde insülin düzeyi, RBC, Hb, Hct ve HbF düzeyi kontrol gurubuyla karşılaştırıldığında anlamlı olarak yüksekti(p<0.01). Diyabetik anne bebekleri ve kontrol gurubu arasında Epo düzeyleri için fark bulunmadı.Diyabetik annelerdeki 3-pHB düzeyi ile bebeklerindeki RBC, Hb, Hct, ve HbF düzeyleri arasında pozitif korelasyon saptadık(p<0.01). Sonuç olarak diyabetik anne bebeklerinde, artmış 3-PHB düzeyi polistemiye neden olabilir ve annedenki açlık 3-PHB düzeyinin kontrolü, polistemi insidansını azaltmada yardımcı olabilir
The complications in diabetic pregnancy, such as fetal anomalia and perinatal mortality, have decreased during last 3 decads. However, metabolic disturbances such as macrosomia, hypoglycemia, polycythemia are still major problems for infants of diabetic mothers(IDMs). Both pregestational diabetes and gestational diabetes lead to metabolic complications. Tissue hypoxemia, hyperbilirubinemia, hypoglycemia, respiratory distress, apnea, convulsion, renal impairment and cardiac failure could occur in polycythemic infants related to hyperviscosity and excessive erythrocyte mass. The pathogenesis of the polycythemia have not been fully understood. Pregnant women with pregestational and gestational diabetes and their term newborn infants in Ege University Medical Faculty, department of obstetrics and pediatrics, were included the study. Maternal fasting blood 3-3 hydroxybutirate (3-PHB) and glycolysated Hb (HbAic) were tested in 34-36 weeks of gestation. Birth weight, apgar scores, serum insulin and erythropoietin (Epo), RBC, hemoglobin and HbF levels in cord blood and venous hematocrit were studied in infants on 4th hours of birth. Maternal 3-pHB and HbAic levels in diabetic group were found to be significantly higher than control(p<0.001, p<0,05). Birth weight of IDMs were significantly higher than control; and macrosomia was observed in 40%. The levels of insulin, RBC, Hb, Hct, HbF in IDMs were significantly elevated compered with control group(p<0,01). 55The levels of Epo between IDMs and control group were not different. We documented positive correlation between maternal 3-3HB and RBC counts, Hb, Hct, HbF levels in IDMs. In conclusion; elevated 3-pHB could lead to polycythemia in IDMs and control of the maternal fasting blood 3-3HB level, may helpfull for decreasing the incidence of polycythemia. 56
The complications in diabetic pregnancy, such as fetal anomalia and perinatal mortality, have decreased during last 3 decads. However, metabolic disturbances such as macrosomia, hypoglycemia, polycythemia are still major problems for infants of diabetic mothers(IDMs). Both pregestational diabetes and gestational diabetes lead to metabolic complications. Tissue hypoxemia, hyperbilirubinemia, hypoglycemia, respiratory distress, apnea, convulsion, renal impairment and cardiac failure could occur in polycythemic infants related to hyperviscosity and excessive erythrocyte mass. The pathogenesis of the polycythemia have not been fully understood. Pregnant women with pregestational and gestational diabetes and their term newborn infants in Ege University Medical Faculty, department of obstetrics and pediatrics, were included the study. Maternal fasting blood 3-3 hydroxybutirate (3-PHB) and glycolysated Hb (HbAic) were tested in 34-36 weeks of gestation. Birth weight, apgar scores, serum insulin and erythropoietin (Epo), RBC, hemoglobin and HbF levels in cord blood and venous hematocrit were studied in infants on 4th hours of birth. Maternal 3-pHB and HbAic levels in diabetic group were found to be significantly higher than control(p<0.001, p<0,05). Birth weight of IDMs were significantly higher than control; and macrosomia was observed in 40%. The levels of insulin, RBC, Hb, Hct, HbF in IDMs were significantly elevated compered with control group(p<0,01). 55The levels of Epo between IDMs and control group were not different. We documented positive correlation between maternal 3-3HB and RBC counts, Hb, Hct, HbF levels in IDMs. In conclusion; elevated 3-pHB could lead to polycythemia in IDMs and control of the maternal fasting blood 3-3HB level, may helpfull for decreasing the incidence of polycythemia. 56
Açıklama
Anahtar Kelimeler
Çocuk Sağlığı ve Hastalıkları, Child Health and Diseases
