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Vojnosanitetski pregled
2019, vol. 76, br. 2, str. 175-185
jezik rada: engleski
vrsta rada: izvorni naučni članak
objavljeno: 25/04/2019
doi: 10.2298/VSP170319083T
Creative Commons License 4.0
Korelacija između koagulacionog i inflamatornog statusa kod bolesnika sa dijabetesom melitusom tip 2 u odnosu na polne razlike - da li postoji uticaj 8-nedeljnog vežbanja?
aUniversity Hospital Ullevål, Physical Medicine and Rehabilitation Department, Oslo, Norway
bUniverzitet u Beogradu, Medicinski fakultet, Univerzitetska dečija klinika + Univerzitet u Beogradu, Medicinski fakultet
cUniverzitet u Beogradu, Medicinski fakultet + Klinički centar Srbije, Beograd

e-adresa: divnatrebinjac@gmail.com

Sažetak

Uvod/Cilj. Hiperkoagulacioni i inflamatorni status kod dijabetičara je opsežno proučavan u dosadašnjim istraživanjima, ali je mogući uticaj fizičkog treninga na međusobnu povezanost između koagulacionog i inflamatornog statusa nedovoljno istražen. Cilj našeg istraživanja bio je ispitivanje korelacija između inflamatornog i koagulacionog statusa kod bolesnika sa dijabetesom melitusom tip 2 u odnosu na pol, kao i uticaj fizičkog treninga na jačinu ovih korelacija i parametre koagulacionog i inflamatornog statusa. Metode. U istraživanje je bilo uključeno 60 bolesnika u stabilnom kliničkom stanju sa dobro regulisanim dijabetesom melitusom tip 2. Trening je primenjen u vidu intervalnog treninga sa maksimalnim intenzitetom od 75% maksimalne srčane frekvence, pet puta nedeljno u toku osam nedelja i treninga u vidu hoda brzinom od 5 km/h u trajanju od trideset minuta, pet puta nedeljno u toku osam nedelja. Sledeći fibinolitički, koagulacioni i inflamatorni parametri su analizirani pre i posle sprovedenog programa treninga: D-dimer, von Willebrand factor (vWF), fibrinogen, visokosenzitivni C-reaktivni protein (hs-CRP), leukociti, trombinsko vreme (TT), protrombinsko vreme (PT), aktivirano parcijalno tromboplastinsko vreme (APTT) i faktori koagulacije - FII, FV, FVII i FX. Rezultati. Naše istraživanje je pokazalo statistički značajno smanjenje nivoa vWF posle studije kod ispitanika muškog (p < 0,001) i ženskog pola (p < 0,001). Pozitivna korelacija između hs-CRP i fibrinogena, pokazana bazalno kod ispitanika muškog (p < 0,05, r = 0,492) i ženskog pola (p < 0,01, r = 0,516) koja bila je slabija kod ispitanika muškog pola (p < 0,01, r = 0,449), odnosno, gubila se kod ispitanica ženskog pola (p < 0,05, r = 0,059) nakon sprovedenog treninga. Pokazane su pozitivne bazalne korelacije kod ispitanika muškog pola između D-dimera sa jedne strane i hs-CRP (p < 0,01, r = 0,633) i fibrinogena (p < 0,01, r = 0,673) sa druge strane, kao i između hs-CRP i FII (p < 0,01, r = 0,728), FV (p < 0,05, r = 0,366), FVII (p < 0,05, r = 0,373, kao i između D-dimera i FII (p < 0,01, r = 0,851) i FVII (p < 0,05, r = 0,367), dok te korelacije nisu pokazane kod ispitanica ženskog pola. Naše istraživanje je kod ispitanika muškog pola pokazalo slabljenje jačine korelacija nakon sprovedenog treninga između D-dimera i hs- CRP (p < 0,05, r = 0,378), hs-CRP i FII (p < 0,01, r = 0,501), FV (p < 0,05, r = 0,298), FVII (p < 0,05, r = 0,351), kao i između D-dimera i FII (p < 0,01, r = 0,759), i FVII (p < 0,05, r = 0,296). Smanjenje nivoa FX kod ispitanica ženskog pola (p < 0,05) nakon sprovedenog treninga ukazuje na mogući antiinflamatorni efekat fizičkog treninga. Zaključak. Prema predhodnim istraživanjima, vWF može biti faktor rizika u populaciji dijabetičara i njegov povišeni nivo je povezan sa rizikom od nastanka kardiovaskularnog oboljenja. Mi smo pokazali da fizički trening u trajanju od osam nedelja može znacajno smanjiti nivo vWF kod oba pola, ukazujući na potencijalni povoljni efekat na parametre endotelne funkcije. Naše istraživanje je pokazalo veću jačinu korelacija između koagulacionih i inflamatornih parametara kod ispitanika muškog pola u odnosu na ispitanice ženskog pola. Prema našim rezultatima, osmonedeljni fizički trening dovodi do slabljenja jačine korelacija između koagulacionih i inflamatornih parametara kod ispitanika muškog pola i slabljenje ovih korelacija do potpunog gubitka kod ispitanica ženskog pola, ukazujući na jedinstveni efekat fizičkog treninga koji bi trebalo da bude ispitan u budućim istraživanjima.

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