Tıpta Uzmanlık Tezleri
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12645/18341
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Browsing Tıpta Uzmanlık Tezleri by Subject "Antioksidanlar = Antioxidants"
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Publication İlk trimesterde maternal faktörler ve serum biyomarker kullanımı ile gestasyonel diabetes mellitus öngörüsü sağlanması(Bezmialem Vakıf University, 2017) ÖZKAL MOLLA, Fulya; KILIÇOĞLU DANE, Pakizer BanuFirst-trimester maternal factors and serum biomarkers in prediction of gestational diabetes mellitus. Objective: To examine various biomarkers in early prediction of gestational diabetes mellitus(GDM) in first trimester pregnancy. Materials and methods: This randomized controlled trial was conducted by Department of Obstetrics and Gynecology in the accordence with Bezmialem Vakif University Ethics Committee. A total of 220 non diabetic patients during the first trimester screening were recruited for GDM screening using demographic charecterisitcs and maternal serum albumin, creatinine, uric asid, hs-CRP, sex-hormone binding globuline (SHBG), and oxidative stres parameters by thiol/disulphide levels. Gdm diagnosis established by 75gr glucose challange test. Results: On follow up cases, we found n =64 women subsequently developed GDM and n=156 women without GDM. There were significant difference between groups for gravity (group 1: 2, group 2: 3; p<0,05), and also significant difference in BMI (group 1: 24.1, group 2: 27.8; p=0,001). There were no relevant difference in parity, height and smoking status. Maternal serum albumin (group 1: 3.47, group 2: 3.59; p= 0,034), creatinine (group 1: 0.40, group 2: 0.45; p= 0,007), uric asid (group 1: 2.25, group 2: 2.53; p= 0,026) levels were significantly higher among GDM group (Group 2). SHBG levels were significantly low in GDM group compared with normoglycemic group (group 1: 246.62, group 2: 223.70 ; p=0,003). However, serum hs-CRP levels were not significantly different between both groups. Tas (group 1: 1.27, group 2: 1.01; p < 0,0001), Tos (group 1: 12.86, group 2: 15.65; p < 0,0001), and Osi (group 1: 0.97, group 2: 1.36; p < 0,0001) levels showed significat difference women who subsequently diagnosed with GDM. Yapılan ROC analizinde GDM için BMI ve biyokimyasal parametrelerden albümin, kreatinin, ürik asit ve SHBG'nin anlamlı olduğu saptandı. Sırasıyla VKİ için eşik değer 27,53 alındığında ve SHBG için eşik değer 197,7 alındığında en anlamlı sonuçlar elde edilmiştir (sırasıyla p= 0,0006, p=0,0035). GDM bağımlı değişken alınarak yapılan lojistik regresyon analizinde, kreatinin yüksekliğinin (eşik değer 0,48mg/dl olarak alındığında ) GDM üzerinde 2,57 (p= 0,012) kat daha fazla GDM riski getirdiği ve SHBG düşüklüğünün (eşik değer 197,7nmol/L olarak alındığında) de 2,95 (p=0,001) kat GDM riski getirdiği saptandı. In the ROC analysis, BMI and biochemical parameters including albumin, creatinine, uric acid and SHBG were found to be significant for GDM. The most significant results were obtained when the threshold value for VKI was 27.53 and the threshold value for SHBG was 197.7(p = 0.0006, p = 0.0035, respectively). In the logistic regression analysis using GDM dependent variables, higher creatinine levels (threshold value of 0.48 mg/dL) increased GDM risk 2.57 (p = 0.012) times and lower SHBG (threshold value of 197.7 nmol/L) increased GDM risk 2.95 (p = 0.001) times. Conclusion:Serum albumin, creatinine, uric asid, SHBG, and oxidative stres parameters levels appear to have value in GDM prediction. Further studies are needed to establish diagnostic accuracy of biomarkers when combined to each other.