Akut kolesistit taný ve evrelendirmesinde Nesfatin-1’in prognostik etkisi

AMAÇ: Safra kesesi hastalýklarý geliþmiþ ülkelerde nüfusun yaklaþýk %20’sini etkileyen önemli bir saðlýk sorunudur. Akut kolesistit, safra taþý hastalýðýnýn en yaygýn komplikasyonudur ve tipik olarak semptomatik safra taþý öyküsü olan hastalarda geliþir. Çalýþmamýzýn amacý kolay uygulanabilen, hýzlý sonuç veren ve enflamatuvar olaylarla iliþkisi olduðu düþünülen bir belirteç olan nesfatin-1’in; akut kolesistitin tanýsýnda ve evrelendirilmesinde kullanýlabilirliðini deðerlendirmektir.
GEREÇ VE YÖNTEM: Çalýþmaya Ýstanbul Eðitim ve Araþtýrma Hastanesi’ne 01.07.2020 ile 01.12.2020 tarihleri arasýnda akut kolesistit ile baþvuran ve hastaneye yatýrýlarak tedavi gören hastalar alýndý. Hastalar rutin kan incelemeleri ve görüntüleme yöntemleri baz alýnarak yapýlan Tokyo Guidelines 2018 sýnýflamasýna göre hafif, orta ve aðýr þiddette kolesistit olarak üç ana gruba ayrýldý. Çalýþmaya dahil edilen tüm hastalardan yatýþ sonrasý 24 saat içinde kan alýnarak kanda lökosit, nötrofil, lenfosit, nötrofil/lenfosit ve nesfatin-1 seviyeleri ölçüldü.
BULGULAR: Her grupta en az 15 kiþi olmak üzere saðlýklý gönüllüler, hafif kolesisit, orta kolesistit ve aðýr kolesistit olarak toplam 61 gönüllü çalýþmaya dahil edildi. Çalýþmaya katýlanlarýn ortalama yaþý 58.11±19.76 yýl, kadýn oraný yüzde 47.54 ve erkek oraný 52.46 idi. Çalýþmada hasta gruplarýndaki nesfatin-1 deðerleri kontrol grubuna göre düþük saptanmýþtýr. Alt grup analizlerinde orta hasta grubundaki nesfatin-1 deðerleri kontrol grubuna göre anlamlý olarak daha düþük bulunmuþtur; ancak hastalýðýn þiddeti ile nesfatin-1 arasýnda anlamlý istatistiksel bir iliþki görülmemiþtir.
TARTIÞMA: Sonuç olarak nesfatin-1 hastalýðýn tanýsý için klinisyeni yönlendirebilir; ancak nesfatin-1 ile hastalýðýn þiddeti veya evresi arasýnda anlamlý iliþki bulunmamýþtýr. Bulgularýmýz gelecekteki çalýþmalar için umut vericidir.

Prognostic effect of Nesfatin-1 on the diagnosis and staging of acute cholecystitis

BACKGROUND: Gallbladder diseases are an important health concern affecting approximately 20% of the population in developed countries. Acute cholecystitis is the most common complication of gallstones. The aim of our study is to determine the use of Nesfatin-1, which is an easily applicable and fast resulting and is thought to have an association with inflammatory events, in the diagnosis and grading of acute cholecystitis.
METHODS: Patients who admitted and were hospitalized and treated with the acute cholecystitis diagnosis in Ýstanbul Training and Research Hospital between July 1, 2020, and December 1, 2020, were included in the study. The patients were divided in threemain groups as mild, moderate, and severe according to Tokyo Guidelines 2018 based on their routine blood tests and imaging results. All patients who are included in the study were tested for their blood leukocyte, neutrophil, lymphocyte, Nesfatin-1 levels, and neutrophil/lymphocyte ratios within the first 24 h of their hospitalization.
RESULTS: With at least 15 patients in each group, 61 volunteers in total were included in the study as healthy volunteers, mild, moderate, and severe cholecystitis. The average age of the participants were 58.11±19.76 years. About 47.54% of the participants were female and 52.46% weremale. In the study, Nesfatin-1 levels in the patient groups were found to be lower than the control group. In the subgroup analyzes, Nesfatin-1 values in the middle patient group were found to be significantly lower than the control group; however, there was no statistically significant relationship between the severity of the disease and Nesfatin-1.
CONCLUSION: Nesfatin-1 may guide the clinician for the diagnosis of the disease; however, no significant relationship was found between Nesfatin-1 and the severity or stage of the disease.