Öz
Amaç
Primer hiperparatiroidizm (PHPT), kardiyovasküler mortalite ve hipertansiyon ile ilişkilidir. Arteriyel sertlik, kardiyovasküler olayların bir öngörücüsüdür. Bu çalışmanın amacı, PHPT’li hastalarda 24 saatlik ambulatuvar kan basıncı izlemi (ABPM) yöntemi kullanarak, arteriyel sertliği ve gündüz ve gece ortalama arteriyel basınçlarını araştırmak ve bunların renin, aldosteron ve diğer biyokimyasal parametrelerle ilişkisini ortaya koymaktır.
Yöntemler
Çalışmaya PHPT’li 35 hasta ve 32 sağlıklı kontrol katıldı. Tüm çalışma katılımcılarına 24 saatlik ABPM cihazı takıldı. Renin ve aldosteron seviyeleri ölçüldü ve diğer gerekli biyokimyasal testler yapıldı. Arteriyel sertliği değerlendirmek için nabız dalga hızı (PWV) ve augmentasyon indeksi (AIX) kullanıldı.
Bulgular
Hastaların ortalama renin seviyeleri kontrol grubuna göre anlamlı olarak daha yüksekti (p<0,05). Hastaların gündüz ve gece ortalama arteriyel basınçları kontrol grubundan anlamlı olarak daha yüksekti (p<0,05). İki grubun PWV ve AIX sonuçları arasında istatistiksel olarak bir fark saptanmadı (p>0,05). Gündüz ve gece ortalama arter basınçları 25-hidroksi D vitamini seviyesiyle pozitif korelasyon gösterdi, ancak kalsiyum, paratiroid hormonu veya renin, aldosteron seviyeleriyle anlamlı korelasyon göstermedi. Beş hastaya ABPM’ye göre yeni hipertansiyon tanısı konuldu.
Sonuç
Çalışmamız, düşük kardiyovasküler riske sahip olan PHPT hastalarında ABPM ile saptanan arteriyel sertliğin yüksek olmadığını göstermektedir. PHPT, artmış ortalama arter basıncı ve artmış renin seviyeleri ile ilişkilidir. ABPM, PHPT’de hipertansiyonu erken tespit edebilir. PHPT’de 25-hidroksi D vitamini seviyesi ile ortalama arter basıncı arasındaki pozitif korelasyonun daha fazla çalışma ile desteklenmesi gerekmektedir.
Anahtar Kelimeler: Primer hiperparatiroidizm, arteriyel sertlik, nabız dalga hızı (PWV), augmentasyon indeksi (AIX), renin, aldosteron, ortalama arter basıncı (MAP)
Kaynakça
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