Odnos između dijabetičke retinopatije, mikroalbuminurije i asimptomatske disfunkcije lijeve srčane klijetke u bolesnika sa šećernom bolešću tipa 1

doctoral thesis

• Title (english): The relationship between diabetic retinopathy, microalbuminuria and asymptomatic left ventricular dysfunction in patients with type 1 diabetes mellitus
• Author: Kajo Bućan; MBZ: 227842
• Mentor: Lovro Bojić (mentor)
• Committee member: nije dostupno (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2008-11-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences
• Universal decimal classification (UDC): 61 - Medical sciences

Abstract

Endotelno-vaskularna disfunkcija je temeljni čimbenik u etiologiji razvoja kasnih kliničkih komplikacija u bolesnika sa ŠBT1 uključujući dijabetičku retinopatiju, dijabetičku nefropatiju (u samom početku karakteriziranu mikroalbuminurijom) i disfunkciju lijeve srčane klijetke. Ciljevi rada bili su odrediti u bolesnika sa ŠBT1 i klinički (ne)evidentnom dijabetičkom retinopatijom bez ili s mikroalbuminurijom asimptomatsku disfunkciju lijeve srčane klijetke te utvrditi povezanost trajanja ŠBT1 s pojavom dijabetičke retinopatije, mikroalbuminurije i asimptomatske disfunkcije lijeve srčane klijetke. Ispitano je 120 odabranih bolesnika sa ŠBT1 (normotenzivni, bez dijabetičke neuropatije), koji su svrstani s obzirom na nalaz fundoskopije (oftalmoskopski, fundus fotografija i fluoresceinska angiografija) i mikroalbuminurije (turbodimetrijskom metodom), u tri skupine: a) bolesnici bez dijabetičke retinopatije i bez mikroalbuminurije (N=40); b) bolesnici s dijabetičkom retinopatijom bez mikroalbuminurije (N=40); c) bolesnici s dijabetičkom retinopatijom i mikroalbuminurijom (N=40). Kod svih bolesnika izvršeno je ergometrijsko testiranje i ehokardiografsko ispitivanje dvodimenzijskom (2-D) i pulsnom Dopler-ehokardiografskom tehnikom. Kod sve tri skupine bolesnika sa ŠBT1 (niskog profila kardiovaskularnog rizika, uredne reguliranosti i bez dijabetičke neuropatije) srednje vrijednosti ehokardiografskih varijabli bile su unutar referentnih vrijednosti i nismo našli statistički značajnu razliku u vrijednostima ehokardiografskih varijabli između skupine bolesnika sa ŠBT1 i dijabetičkom retinopatijom i skupine bolesnika sa ŠBT1 i dijabetičkom retinopatijom i mikroalbuminurijom. Između skupine bolesnika s dijabetičkom retinopatijom i skupine bolesnika s dijabetičkom retinopatijom i mikroalbuminurijom zajedno utvrdili smo statistički značajnu razliku u vrijednostima ehokardiografskih varijabli prema skupini bolesnika bez komplikacija, ali unutar referentnih vrijednosti. Konačno, utvrđena je statistički značajna povezanost između trajanja ŠBT1 i nazočnosti dijabetičke retinopatije i mikroalbuminurije. Nismo utvrdili statistički značajnu povezanost između trajanja ŠBT1 i ispitivanih ehokardiografskih varijabli.

Abstract (english)

Vascular endothelial dysfunction is basic etiological factor for the development of late clinical complications in patients with diabetes mellitus type 1, such as diabetic retinopathy, diabetic nephropathy (which is characterized at the very beginning by microalbuminuria) and left ventricle cardiac dysfunction. The aims of this study were to determine the prevalence of asymptomatic left ventricle dysfunction in patients with diabetes mellitus type 1, subclinical diabetic retinopathy, and with or without microalbuminuria. Second aim was to correlate duration of the diabetes with the dynamics of diabetic retinopathy, microalbuminuria, and asymptomatic left ventricle dysfunction development in patients with diabetes mellitus type 1. One-hundred and twenty chosen patients with diabetes type 1 were examined (normotensive, without diabetic neuropathy), which were divided in three groups accordingly to their fundus findings (ophthalmoscopy, fudnus photography, fluorescein angiography) and microalbuminuria (turbidimetric method): a) patients without diabetic retinopathy and without microalbuminuria (N=40); b) patients with diabetic retinopathy without microalbuminuria (N=40); c) patients with diabetic retinopathy and microalbuminurua (N=40). All patients did ergometric testing and two-dimensional (2-D) echocardiography with pulsed Doppler. All three groups of patients with diabetes mellitus type 1 (with low cardiovascular risk, regulated blood sugar, and without diabetic neuropathy) had echocardiographic values in the normal range, and we did not find any statistically significant difference between values in the group of patients with diabetes mellitus type 1 and diabetic retinopathy and values in the group of patients with diabetes mellitus type 1, diabetic retinopathy, and microalbuminuria. Statistically significant difference in echocardiographic values was found between the group with diabetic retinopathy and the group with diabetic retinopathy and microalbuminuria when compared with the group without complications, but with values within the normal range. We have not found statistically significant correlation between the duration of diabetes mellitus type 1 and echocardiographic values.

• Keywords: medicina
• Keywords (english): medicine
• Language: croatian
• URN:NBN: urn:nbn:hr:105:547005
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstva (doktor/doktorica znanosti, područje biomedicine i zdravstva)
• Type of resource: Text
• Extent: 159 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-05-05 08:48:58