Abstract | Cilj: Svrha ovog istraživanja bila je ispitati odnos između sastava tijela i distribucije tjelesne masti i razvoja kroničnih komplikacija u pacijenata sa šećernom bolesti tipa 2, kao i procijeniti povezanost između sastava tijela i regulacije glikemijskih vrijednosti.
Ispitanici i postupci: Istraživanje je provedeno u Centru za dijabetes Zavoda za endokrinologiju, dijabetologiju i bolesti metabolizma KBC-a Split. Rađeno je na 65 ispitanika sa šećernom bolesti tipa 2, od kojih 27 muškaraca i 38 žena. Za prikupljanje podataka korištena je medicinska dokumentacija ispitanika uz ispunjavanje anketnog upitnika, rađena su antropometrijska mjerenja metodom bioelektrične impedancije (uređaj TANITA) čime je izmjeren sastav tijela ispitanika, te su mjereni opsezi struka, bokova i natkoljenice, tjelesna masa i visina ispitanika.
Rezultati: Veliki broj ispitanika imao je lošu regulaciju glikemije, a žene su imale nešto lošiju regulaciju u odnosu na muškarce (P=0,051). Analiza sastava tijela je pokazala da je 40% ispitanika pretilo, dok je 21,5% imalo prekomjerne vrijednosti ukupne tjelesne masti. Neuropatija i kardiovaskularne bolesti bile su najzastupljenije kronične komplikacije šećerne bolesti tipa 2. Kronične komplikacije bile su općenito nešto učestalije u žena, dok je neuropatija statistički značajno učestalije zastupljena u ženskoj populaciji (P=0,015). Ispitanici s lošijom regulacijom glikemije imali su više komplikacija u odnosu na dobro regulirane (nefropatija P=0,005; retinopatija P=0,024). Muškarci s kroničnim komplikacijama imali su manji postotak mišićne mase, veći postotak ukupne tjelesne masti i visceralne tjelesne masti u odnosu na one bez komplikacija, osim onih s retinopatijom koji su imali veći postotak mišićne mase, manji postotak ukupne tjelesne masti i visceralne tjelesne masti u odnosu na one bez retinopatije (P>0,05). Žene s kroničnim komplikacijama imale su veći postotak visceralne tjelesne masti (nefropatija P=0,029), kod neuropatije i kardiovaskularnih bolesti veći postotak mišićne mase i manji postotak ukupne tjelesne masti, a kod nefropatije i retinopatije manji postotak mišićne mase i veći postotak ukupne tjelesne masti (P>0,05), u odnosu na one bez kroničnih komplikacija.
Zaključak: Rezultati impliciraju povezanost pojave kroničnih komplikacija šećerne bolesti tipa 2 i razina masti. Ipak, zbog nedosljednosti prikazanih rezultata među različitim komplikacijama, kao i s podacima iz dostupne literature, potrebno je provesti daljnje multicentrične studije na većem uzorku ispitanika da se detaljnije objasne navedeni utjecaji. |
Abstract (english) | Objectives: The aim of this study was to examine relations between body composition and fat distribution and development of chronic complications in patients with diabetes mellitus type 2, as much as to evaluate relations between body composition and glycemic control.
Subjects and Methods: The study was conducted at the Center for Diabetes, Institute of Endocrinology, Diabetology and Metabolic Diseases of the University Hospital of Split. It was made on 65 participants with diabetes mellitus type 2, of which 27 male and 38 female. Medical documentation and survey questionnaire were used to collect data, anthropometric measurements based on bioelectrical impedance (TANITA device) were made to measure body composition of participants, and circumferences of waist, hips and thighs, body weight and height were also measured.
Results: Large number of participants had bad glycemic control and women had slightly worse glycemic control than men (P=0.051). Body composition analysis showed that 40% of our participants were obese, while 21.5% had excessive values of total body fat. Neuropathy and cardiovascular diseases were most common chronic complications of diabetes mellitis type 2. Chronic complications were in general somewhat more common in women, while neuropathy was significantly more often found in women (P=0.015). Participants with bad glycemic control had more complications than those well controlled (nephropathy P=0.005; retinopathy P=0.024). Men with chronic complications had a smaller percentage of muscle mass and higher percentage of total and visceral body fat than those without complications, except for those with retinopathy who had higher percentage of muscle mass and smaller percentage of total and visceral body fat than those without retinopathy (P>0.05). Women with chronic complications had higher percentage of visceral body fat (nephropathy P=0.029), those with neuropathy and cardiovascular diseases had also higher percentage of muscle mass and smaller percentage of total body fat, and those with nephropathy and retinopathy had smaller percentage of muscle mass and higher percentage of total body fat (P>0.05) than those without complications.
Conclusions: Results imply that there is a connection between chronic complications of diabetes mellitus type 2 and body fat level. Nevertheless, because of the inconsistency of showed results between different complications, such as with data from available literature, future multicentric studies on larger sample of participants are needed to be done for detailed explanations of mentioned influences. |